Provider Demographics
NPI:1528807732
Name:KERESTIR HEALTH LLC
Entity type:Organization
Organization Name:KERESTIR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTOSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-534-0689
Mailing Address - Street 1:501 STATE ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 STATE ROUTE 208
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1611
Practice Address - Country:US
Practice Address - Phone:718-534-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty