Kristen Ann Dougherty

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

1114167 Issued in NY

Practice address

2861 Chester St
Oceanside, NY 11572-1233

Phone

(516) 528-1915

NPI assigned

Jun 24, 2025

Last updated

Jun 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kristen Ann Brand Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1275421786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 CHESTER ST",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721233",
            "telephone_number": "516-528-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 CHESTER ST",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721233",
            "telephone_number": "516-528-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1114167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BRAND",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas V. Difusco, D.C.
• Amy Elizabeth Digiovanni
• Marisa Dimartino, LMHC
• Donald G. Russ, P.T., D.P.T., P.C.
• Jason Marc Donin, PT, DPT
• Dr Asher Diamond DDS PLLC
• Dr. Michael J Heiss Dental PLLC (Pearly Whites Dental Studio)
• Steven A. Drexler, M.D.
• Michael Drozdick, LMHC
• Rossy E. Duarte, DO

• Early Intervention Provider Agency in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.