Provider Demographics
NPI:1376577817
Name:KERIN, MICHAEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:KERIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 STONE PL
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3426
Mailing Address - Country:US
Mailing Address - Phone:914-793-0996
Mailing Address - Fax:914-793-9878
Practice Address - Street 1:1 STONE PL
Practice Address - Street 2:SUITE 303
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3426
Practice Address - Country:US
Practice Address - Phone:914-793-0996
Practice Address - Fax:914-793-9878
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218921208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02103482Medicaid
NYH24542Medicare UPIN
NY40P721Medicare ID - Type Unspecified