Provider Demographics
NPI:1154624864
Name:CASABIANCA & KYROU, DPM, PC
Entity type:Organization
Organization Name:CASABIANCA & KYROU, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KYROU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-838-8480
Mailing Address - Street 1:1007 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6165
Mailing Address - Country:US
Mailing Address - Phone:845-227-6947
Mailing Address - Fax:845-227-6729
Practice Address - Street 1:400 WESTAGE BUSINESS CTR DR
Practice Address - Street 2:SUITE 210
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2223
Practice Address - Country:US
Practice Address - Phone:845-838-8480
Practice Address - Fax:845-838-8474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005423213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P1225508OtherOXFORD
1010284OtherCDPHP
1915529OtherUNITED HEALTHCARE
NY01912770Medicaid
P00019837OtherRAILROAD MEDICARE
PO8993OtherBLUE CROSS
9663950002OtherCIGNA
1499622OtherGHI
4C3361OtherHEALTHNET
392789OtherMVP
3187013OtherAETNA
PO5346-3WOtherWORKERS COMPENSATION
392789OtherMVP
1915529OtherUNITED HEALTHCARE
3187013OtherAETNA
=========OtherUNICARE
NY01912770Medicaid
NY01912770Medicaid
=========OtherNATN'L BENEFITS 1199