Active NPI
Dorothy Kernizan
- Case Manager/Care Coordinator
- Syosset, NY
National Provider Identifier
1467715227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 14979
- Practice address
- 2 Roosevelt Ave
Suite 300
Syosset, NY 11791-3064 - Phone
- (516) 551-0699
- Fax
- (516) 921-4432
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 14979 | NY | Primary |
Addresses
Primary practice location
2 Roosevelt Ave
Suite 300
Syosset, NY 11791-3064
Mailing address
797 East Gate
Valley Stream, NY 11580
Phone (516) 551-0699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14979 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339977600000",
"number": "1467715227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "797 EAST GATE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11580",
"telephone_number": "516-551-0699",
"fax_number": "516-921-4432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 ROOSEVELT AVE",
"address_2": "SUITE 300",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117913064",
"telephone_number": "516-551-0699",
"fax_number": "516-921-4432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNIZAN",
"first_name": "DOROTHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2012-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NY",
"license": "14979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.