MK HEALTHCARE MEDICAL PC NPI 1316426299

NPI Information

MK HEALTHCARE MEDICAL PC is a specialist in Ridgewood, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MK HEALTHCARE MEDICAL PC NPI is 1316426299. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5629 METROPOLITAN AVE
RIDGEWOOD, NY
ZIP 11385
Phone: (718) 418-0300
Fax: (718) 418-0301

The provider's authorized official is Paul Ambar .
The authorized official title is Credentialing Manager and has the following contact phone number (917) 748-1913.

The CLIA number assigned to this NPI record is 33D1063185 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2018 and was last updated on 9/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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