Provider Demographics
NPI:1699850289
Name:DRS KIERSTEIN & DIFRANCESCA DPM, PC
Entity Type:Organization
Organization Name:DRS KIERSTEIN & DIFRANCESCA DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFEREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-447-1488
Mailing Address - Street 1:196 PARKWAY S
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1234
Mailing Address - Country:US
Mailing Address - Phone:860-442-7027
Mailing Address - Fax:860-444-0074
Practice Address - Street 1:196 PARKWAY S
Practice Address - Street 2:SUITE 302
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1234
Practice Address - Country:US
Practice Address - Phone:860-447-1488
Practice Address - Fax:860-447-1489
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS KIERSTEIN & DIFRANCESCA DPM, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3946230001Medicare NSC