MEDICARE: ANDREA SIOBHAN KIERANS 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	2085R0202X	Diagnostic Radiology Physician	2746811	NY

General Provider Information

NPI Number	:	1649408881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SIOBHAN KIERANS M.D.

Provider Business Mailing Address
First Line	:	525 E 72ND ST APT 36A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-9611
Country	:	US
Telephone Number	:	508-265-1482
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E 72ND ST APT 36A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-9611
Country	:	US
Telephone Number	:	508-265-1482
Fax Number	:

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

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	03/27/2023

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