Konrad Kiecun

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3705 80TH St
Jackson Heights, NY 11372-6870

Phone

(929) 229-9085

NPI assigned

Apr 27, 2022

Last updated

Apr 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1861136566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11506 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 80TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726870",
            "telephone_number": "929-229-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIECUN",
        "first_name": "KONRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lotifun Nessa Khandaker, PHARMD
• Ferdous Khandker
• Tenzin Khandoe, FNP-C
• Rakhilya Kholdarova, PA
• Kids Garden Medical Care
• Ah-Hyun Kim
• Chulsoon Kim, M.D.
• Hae Suk Kim
• Hyoungju Kim, PHARMD
• Inok Kim, LCSW

• Case Manager/Care Coordinator in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.