Physician Compare National (NPI:1255868667)

HEALTHCARE PROVIDER: AKIVA KENIGSBERG DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255868667
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638417793
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200903003203
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KENIGSBERG
	Individual professional last name
Provider First Name	AKIVA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7101 147TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	401B
	Group Practice or individual's line 2 address
City	FLUSHING
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113672003
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9084729149
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M