Provider Demographics
NPI:1689794067
Name:KERSON, DON (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:
Last Name:KERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:861 MANHATTAN AVE
Mailing Address - Street 2:#3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2585
Mailing Address - Country:US
Mailing Address - Phone:718-383-3493
Mailing Address - Fax:718-349-3939
Practice Address - Street 1:861 MANHATTAN AVE
Practice Address - Street 2:#3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2585
Practice Address - Country:US
Practice Address - Phone:718-383-3493
Practice Address - Fax:718-349-3939
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1506092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY24E841Medicare ID - Type Unspecified