Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 0188 | NH |
Y | 213EP1101X | Primary Podiatric Medicine | 1789 | MA |
N | 213EP1101X | Primary Podiatric Medicine | P00001988 | FL |
NPI | 1073636338 |
---|---|
Provider Name | Dr. Robert E. Kirsner |
First Address | Newburyport, MA 01950-2603 |
Second Address | Newburyport, MA 01950-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0362417 | (05) | MA |
2701772 | EVERCARE (01) | MA |
T58799 | (02) | MA |