Provider Demographics
NPI:1922302561
Name:CASABIANCA & KYROU, DPM, PC
Entity Type:Organization
Organization Name:CASABIANCA & KYROU, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KYROU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-227-6947
Mailing Address - Street 1:1007 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6165
Mailing Address - Country:US
Mailing Address - Phone:845-227-6947
Mailing Address - Fax:845-227-6729
Practice Address - Street 1:THE ATRIUM AT ST. FRANCIS
Practice Address - Street 2:SUITE 301
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1362
Practice Address - Country:US
Practice Address - Phone:845-483-5809
Practice Address - Fax:845-483-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005423213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1499622OtherGHI
392789OtherMVP
4C3361OtherHEALTHNET
3187013OtherAETNA
9663950002OtherCIGNA
1915529OtherUNITED HEALTHCARE
P08993OtherBLUE CROSS
PO5346-3WOtherWORKERS COMPENSATION
NY01912770Medicaid
1010284OtherCDPHP
P00019837OtherRAILROAD MEDICARE
P1225508OtherOXFORD
3187013OtherAETNA
9663950002OtherCIGNA