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Contact Information

CHRIS J KIELBASA, DO
232 4TH AVE
GREENPORT, NY11944-1526
 Phone: 631-477-0070
 Fax: 631-477-8983
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for CHRIS J KIELBASA · (Male)

NPI # 1184672636
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/05/2006
Last updated 05/19/2026 - About 3 weeks ago
Sole proprietor 1 No
Identifiers
  • NY License # 214789
  • NY Medicaid 20823825
Hospital affiliation(s)
  • PECONIC BAY MEDICAL CENTER - (Acute Care)
    1300 ROANOKE AVENUE
    RIVERHEAD, NY 11901
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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