Kimberly Bickard
Individual provider Active NPI Specialist · Bethpage, NY
NPI 1124486576 · NPPES record last updated Oct 27, 2016
Key facts
- NPI
- 1124486576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 192 N 2ND St
Bethpage, NY 11714-2102 - Phone
- (516) 384-9209
- NPI assigned
- Jan 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
192 N 2ND St
Bethpage, NY 11714-2102
Mailing address
192 N 2ND St
Bethpage, NY 11714-2102
Phone (516) 384-9209
Other providers in Bethpage, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.