Healthcare Provider Details

I. General information

NPI: 1497337760
Provider Name (Legal Business Name): JAMES PETER KIERNAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 THEODORE FREMD AVE
RYE NY
10580-1410
US

IV. Provider business mailing address

9 NEW ST APT 2G
EASTCHESTER NY
10709-3531
US

V. Phone/Fax

Practice location:
  • Phone: 914-921-6061
  • Fax:
Mailing address:
  • Phone: 347-324-8498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number047164
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: