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Alan Michael Kisner, M.D.

Specialist in Huntington, NY. Individual provider (NPI-1).

NPI number1790766673
StatusActive
Last updated in NPPESJun 18, 2008

Details

NPI
1790766673
Entity type
Individual (NPI-1)
Name
Alan Michael Kisner
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 8, 2005
Last updated
Jun 18, 2008

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - PLASTIC AND RECONSTRUCTIVE SURGERY
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist1216841NYYes

Practice location

100 E Main St
Huntington, NY 11743-2816

Phone 631-424-4004 · Fax 631-424-4027

Mailing address

100 E Main St
Huntington, NY 11743-2816

Phone 631-424-4004 · Fax 631-424-4027

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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