Provider Demographics
NPI:1043335516
Name:KIERMAN, CAROL ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:KIERMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3715
Mailing Address - Country:US
Mailing Address - Phone:718-884-7464
Mailing Address - Fax:718-884-7464
Practice Address - Street 1:2550 WEBB AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3930
Practice Address - Country:US
Practice Address - Phone:718-410-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000681-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist