MEDICARE: S&K MEDICAL ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1831309095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S&K MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	345 N MAIN ST
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-4305
Country	:	US
Telephone Number	:	845-634-6500
Fax Number	:	845-634-9424

Provider Business Practice Location Address
First Line	:	17 SQUADRON BLVD
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5214
Country	:	US
Telephone Number	:	845-634-6500
Fax Number	:	845-634-9424

Authorized Official
Title or Position	:	DIRECTOR CODING
Name	:	MARIE FARRELL
Credential	:	RN CCSP
Telephone Number	:	845-634-6500

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	05/21/2009

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