Provider Demographics
NPI:1447234117
Name:KIRSZROT, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:KIRSZROT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-3216
Mailing Address - Country:US
Mailing Address - Phone:718-805-0700
Mailing Address - Fax:718-805-5621
Practice Address - Street 1:300 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1749
Practice Address - Country:US
Practice Address - Phone:201-666-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226463207WX0200X
NJ25MA08774700207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2106680Medicaid
NY2106680Medicaid
NYG400075659Medicare PIN
MAA38808Medicare ID - Type Unspecified
NYA400057350Medicare PIN
NY2106680Medicaid