Healthcare Provider Details

I. General information

NPI: 1730212523
Provider Name (Legal Business Name): DIANE KERSTEIN, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 LEXINGTON AVE STE 111
MOUNT KISCO NY
10549-3638
US

IV. Provider business mailing address

PO BOX 32103
NEW YORK NY
10087-2103
US

V. Phone/Fax

Practice location:
  • Phone: 914-864-1441
  • Fax:
Mailing address:
  • Phone: 914-864-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number173911
License Number StateNY

VIII. Authorized Official

Name: DIANE KERSTEIN
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 914-458-8751