Provider Demographics
NPI: | 1871501213 |
---|---|
Name: | KERSCHNER, DAVID (DC) |
Entity type: | Individual |
Prefix: | DR |
First Name: | DAVID |
Middle Name: | |
Last Name: | KERSCHNER |
Suffix: | |
Gender: | M |
Credentials: | DC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 6 GREENWOOD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | EAST GREENBUSH |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 12061-2036 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 518-477-1080 |
Mailing Address - Fax: | 518-477-1082 |
Practice Address - Street 1: | 6 GREENWOOD DR |
Practice Address - Street 2: | |
Practice Address - City: | EAST GREENBUSH |
Practice Address - State: | NY |
Practice Address - Zip Code: | 12061-2036 |
Practice Address - Country: | US |
Practice Address - Phone: | 518-477-1080 |
Practice Address - Fax: | 518-477-1082 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-08-03 |
Last Update Date: | 2011-03-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | X002195-1 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
350043583 | Other | RAILROAD MEDICARE | |
NY | CO2195-8B | Other | WORKERS' COMPENSATION |
NY | X1320 | Other | EMPIRE BCBS |
100160460 | Other | CDPHP | |
NY | 0039749 | Other | GHI |
350043583 | Other | RAILROAD MEDICARE | |
100160460 | Other | CDPHP |