Individual
DR. MITCHELL G KIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 ROUTE 347 BLDG 14A, STONY BROOK, NY 11790-2554
(631) 689-7800
(631) 689-3016
Mailing address
1500 ROUTE 112 BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 751-3000
(631) 509-6559
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
157097
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00947026
—
NY
01
—
1319
VYTRA
NY
01
—
390001251
MEDICARE RAILROAD
NY
01
—
69D221
EMPIRE BLUECROSS BLUESHIE
NY
01
—
CS664
OXFORD
NY
Enumeration date
06/30/2005
Last updated
01/17/2020
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