Micheal Allan Kieserman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

120479 Issued in NY

Practice address

680 New Salem Rd
Voorheesville, NY 12186-4833

Phone

(518) 765-2151

Fax

(518) 765-3375

NPI assigned

Dec 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396801973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 NEW SALEM RD",
            "city": "VOORHEESVILLE",
            "state": "NY",
            "postal_code": "121864833",
            "telephone_number": "518-765-2151",
            "fax_number": "518-765-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 NEW SALEM RD",
            "city": "VOORHEESVILLE",
            "state": "NY",
            "postal_code": "121864833",
            "telephone_number": "518-765-2151",
            "fax_number": "518-765-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESERMAN",
        "first_name": "MICHEAL",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "120479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00582389",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Glover, RPH, MBA
• Laurie Govel
• Lynn Marie Heffern, LCSW
• Michael Joseph Jarus, D.D.S
• Stephany Keenan
• Marcia J Kindlon, N.P.
• Elizabeth R Knight, PTA
• Kara A Kowalski, LMHC
• Susan Kwiatkowski
• Deborah Jean Lee

• Pediatrics Physician in Voorheesville, NY
• Providers in Voorheesville, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.