Provider Demographics
NPI:1760367445
Name:MARKOVITCH, KIRSTAN (DC)
Entity type:Individual
Prefix:
First Name:KIRSTAN
Middle Name:
Last Name:MARKOVITCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MORGAN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5436
Mailing Address - Country:US
Mailing Address - Phone:917-971-5724
Mailing Address - Fax:917-971-5724
Practice Address - Street 1:90 MORGAN ST STE 202
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5436
Practice Address - Country:US
Practice Address - Phone:203-604-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7.002372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor