1720005481 NPI number — DR. KATHLEEN KIRCHMEIER-KROESSLER MD

Table of content: DR. KATHLEEN KIRCHMEIER-KROESSLER MD (NPI 1720005481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720005481 NPI number — DR. KATHLEEN KIRCHMEIER-KROESSLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRCHMEIER-KROESSLER
Provider First Name:
KATHLEEN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720005481
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
76 PARK ST
Provider Second Line Business Mailing Address:
NEUROLOGY PARTNERS
Provider Business Mailing Address City Name:
ATTLEBORO
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02703-2335
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-431-2026
Provider Business Mailing Address Fax Number:
508-431-2296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
76 PARK ST
Provider Second Line Business Practice Location Address:
NEUROLOGY PARTNERS
Provider Business Practice Location Address City Name:
ATTLEBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02703-2335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-431-2026
Provider Business Practice Location Address Fax Number:
508-431-2296
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  71706 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05-00134 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 201312 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3077390 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3655151002 SCP PALID . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20894-5 . This is a "RHODE ISLAND BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 71706 . This is a "MASSACHUSETTS MED.LISC." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J09034 . This is a "MASSACHUSETTS BLUECROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 04-3507003 . This is a "HEALTH CARE VALUE MANAGEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7609 . This is a "RHODE ISLAND MED. LISC." identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 731785 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11190 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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