Provider Demographics
NPI:1962874271
Name:PARILLO, KRISTEN ELAINE (MS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELAINE
Last Name:PARILLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2565
Mailing Address - Country:US
Mailing Address - Phone:518-690-6275
Mailing Address - Fax:
Practice Address - Street 1:188 LAKE AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2565
Practice Address - Country:US
Practice Address - Phone:518-690-6275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY509504163WP0808X
NY509504-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY509504-1OtherNEW YORK STATE OFFICE OF THE PROFESSIONS