Provider Demographics
NPI:1841247079
Name:DRS KIERSTEIN & DIFRANCESCA DPM, PC
Entity type:Organization
Organization Name:DRS KIERSTEIN & DIFRANCESCA DPM, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:DIFRANCESCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-889-0022
Mailing Address - Street 1:196 PARKWAY S
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1219
Mailing Address - Country:US
Mailing Address - Phone:860-447-1488
Mailing Address - Fax:860-447-1489
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:06385-1219
Practice Address - Country:US
Practice Address - Phone:860-447-1488
Practice Address - Fax:860-447-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01563Medicare PIN
CT3946230002Medicare NSC
CT3946230001Medicare NSC