Provider Demographics
NPI:1255682795
Name:HOWARD A KIERNAN MD PC
Entity Type:Organization
Organization Name:HOWARD A KIERNAN MD PC
Other - Org Name:HOWARD A KIERNAN MD PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:212-602-1800
Mailing Address - Street 1:903 PARK AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0362
Mailing Address - Country:US
Mailing Address - Phone:212-602-1800
Mailing Address - Fax:212-535-4796
Practice Address - Street 1:903 PARK AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0362
Practice Address - Country:US
Practice Address - Phone:212-602-1800
Practice Address - Fax:212-535-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099298174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY641261Medicare PIN
NYB17430Medicare UPIN