Kieran Clasen

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

014318 Issued in NY

Practice address

74 Commerce Ave Ste 3
Riverhead, NY 11901-3105

Phone

(631) 369-9110

Fax

(631) 369-9004

NPI assigned

Nov 19, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1396560983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 COMMERCE AVE STE 3",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013105",
            "telephone_number": "631-369-9110",
            "fax_number": "631-369-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLASEN",
        "first_name": "KIERAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "014318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mike Chung
• Cynthia Cichanowicz, ANP-C
• Michael Emanuel Ciminiello, MD
• City Medical of Upper East Side, PLLC (CityMD Urgent Care)
• Adrienne Clarke, CRNA
• Darcy Clements, REGISTERED DIETITIAN
• Courtney Malia Clemons
• Margaret Clennan, LCSW
• Clubhouse of Suffolk, Inc
• Alisa Coffey, REGISTERED NURSE

• Physical Therapy Assistant in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.