Provider Demographics
NPI:1528067436
Name:ESSAD, KRISTYN A (DO)
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:A
Last Name:ESSAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 DEBARTOLO PL STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6095
Mailing Address - Country:US
Mailing Address - Phone:330-729-8000
Mailing Address - Fax:330-729-8084
Practice Address - Street 1:7629 MARKET ST STE 100
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6051
Practice Address - Country:US
Practice Address - Phone:234-287-6506
Practice Address - Fax:330-965-4889
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-7714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2420071Medicaid
OH2420071Medicaid
OH9269141Medicare PIN
OH9269143Medicare PIN
OH9269142Medicare PIN