Provider Demographics
NPI:1578519930
Name:KROSSER, BARRY I (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:I
Last Name:KROSSER
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 1:1978 CROMPOND ROAD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4146
Mailing Address - Country:US
Mailing Address - Phone:914-739-2121
Mailing Address - Fax:914-739-2185
Practice Address - Street 1:1978 CROMPOND RD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4146
Practice Address - Country:US
Practice Address - Phone:914-739-2121
Practice Address - Fax:914-739-2185
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1842761207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0530960OtherAETNA USHEALTHCARE
NY0D0431OtherHEALTHNET
NY965507OtherMVP
NY01750921Medicaid
NY200028400OtherRAILROAD MEDICARE
NYRS337OtherOXFORD
NY200028400OtherRAILROAD MEDICARE
NY61G822Medicare ID - Type Unspecified
NYF58362Medicare UPIN