Kenneth Howard Pickover, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

164175 Issued in NY

Practice address

59 Revere St
Suite a
Staten Island, NY 10301-3415

Phone

(718) 556-3900

Fax

(718) 273-3592

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1528055076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 REVERE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013415",
            "telephone_number": "718-556-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 REVERE ST",
            "address_2": "SUITE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013415",
            "telephone_number": "718-556-3900",
            "fax_number": "718-273-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKOVER",
        "first_name": "KENNETH",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NY",
            "license": "164175",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "164175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01087645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gia Piccolomini
• Vincent Arthur Piccone II, M.D.
• Lourdes Maria Pichay, M.D.
• Nathaniel Thomas Pickering, MS
• Susan Irene Pickering
• Kristine D. Pico, NP
• Antonio Picon, M.D.,
• Joseph Picone, MD, MPH
• Piecing It Together
• James A Piegari, PH.D.

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.