Kevin J Kriesel, MD | |
826 Washington St Fl 3, Watertown, NY 13601-4064 | |
(315) 788-1751 | |
(315) 788-9021 |
Full Name | Kevin J Kriesel |
---|---|
Gender | Male |
Speciality | Otolaryngology |
Location | 826 Washington St Fl 3, Watertown, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720093883 | NPI | - | NPPES |
151036403 | Medicaid | TX | |
040017071 | Medicaid | TX | |
151036401 | Medicaid | TX | |
151036402 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Y00000X | Otolaryngology | MD457864 (Pennsylvania) | Secondary |
207Y00000X | Otolaryngology | 329201 (New York) | Primary |
207Y00000X | Otolaryngology | L3721 (Texas) | Secondary |
Entity Name | Lehigh Valley Physician Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457309650 PECOS PAC ID: 3072425123 Enrollment ID: O20040227000335 |
Mailing Address | Practice Location Address |
---|---|
Kevin J Kriesel, MD 826 Washington St Fl 3, Watertown, NY 13601-4064 Ph: (315) 788-1751 | Kevin J Kriesel, MD 826 Washington St Fl 3, Watertown, NY 13601-4064 Ph: (315) 788-1751 |
Braxton L Hillerman, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 826 Washington St, Suite 204, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Norman Weir, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 826 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
William I Forbes Iii, MD PHD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 826 Washington St, Suite 204, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
David Christopher Gordon, PH.D., M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Tony C.y. Chuang, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Dr. Albert A. Mcclain Jr., M. D. Otolaryngology Medicare: May Accept Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-786-4824 Fax: 315-786-4915 |