Healthcare Provider Details

I. General information

NPI: 1295750099
Provider Name (Legal Business Name): KERIN B HAUSKNECHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 LANGDON PL
LYNBROOK NY
11563-2414
US

IV. Provider business mailing address

PO BOX 209
HEWLETT NY
11557-0209
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-4451
  • Fax: 516-674-1987
Mailing address:
  • Phone: 516-374-4451
  • Fax: 516-374-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number202181
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number202181
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: