Organization Active NPI

Stephen Kisberg DPM

  • Durable Medical Equipment & Medical Supplies
  • Woodmere, NY
National Provider Identifier
1700056868
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
N002365-1 Issued in NY
Legal business name
STEPHEN KISBERG DPM
Practice address
11 Franklin PL
Woodmere, NY 11598-1216
Phone
(516) 295-2121
Fax
(516) 295-4727
NPI assigned
Mar 5, 2008
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Carlene Walters
Title
Office Administrator
Phone
(516) 295-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X N002365-1 NY Primary

Addresses

Primary practice location

11 Franklin PL
Woodmere, NY 11598-1216

Mailing address

11 Franklin PL
Woodmere, NY 11598-1216
Phone (516) 295-2121

National Provider Directory

National Provider Directory
Tax ID family
Dr Lloyd a Bardfeld3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11 Franklin Pl
Woodmere, NY 11598
Phone (516) 341-0151

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1700056868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981216",
            "telephone_number": "516-295-2121",
            "fax_number": "516-295-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRANKLIN PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981216",
            "telephone_number": "516-295-2121",
            "fax_number": "516-295-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN KISBERG DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "CARLENE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "516-295-2121"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "N002365-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.