MEDICARE: KIRELL PODIATRY ASSOCIATES

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	213EP1101X	Primary Podiatric Medicine Podiatrist	N003755	NY

General Provider Information

NPI Number	:	1942242268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRELL PODIATRY ASSOCIATES

Provider Business Mailing Address
First Line	:	22 HARDWICK DR
Second Line	:
City	:	SOUTH HUNTINGTON
State	:	NY
Zip	:	11746-4550
Country	:	US
Telephone Number	:	631-678-1019
Fax Number	:

Provider Business Practice Location Address
First Line	:	2833 OCEAN PKWY
Second Line	:	SUITE 'A'
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7857
Country	:	US
Telephone Number	:	718-372-4693
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. DONNA SUE KIRELL
Credential	:	D.P.M.
Telephone Number	:	718-372-4693

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/22/2020

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