MEDICARE: DR. JOSEPH F KERBLESKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2454501	NY

General Provider Information

NPI Number	:	1134308471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH F KERBLESKI M.D.

Provider Business Mailing Address
First Line	:	368 BROADWAY STE 202
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-5160
Country	:	US
Telephone Number	:	845-338-7472
Fax Number	:	845-331-4191

Provider Business Practice Location Address
First Line	:	368 BROADWAY STE 202
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-5160
Country	:	US
Telephone Number	:	845-338-7472
Fax Number	:	845-331-4191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	02/11/2022

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