Provider Demographics
NPI:1083737555
Name:OPPENHEIM, KIRA (ANP)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 GRAVESEND NECK RD
Mailing Address - Street 2:APT.3L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4256
Mailing Address - Country:US
Mailing Address - Phone:917-553-4040
Mailing Address - Fax:
Practice Address - Street 1:2327 83RD ST
Practice Address - Street 2:SUITE D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2750
Practice Address - Country:US
Practice Address - Phone:718-236-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402927363LP0808X
NY303630363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health