Healthcare Provider Details

I. General information

NPI: 1336456979
Provider Name (Legal Business Name): KIO MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2752 OCEAN AVE
BROOKLYN NY
11229-4706
US

IV. Provider business mailing address

2752 OCEAN AVE
BROOKLYN NY
11229-4706
US

V. Phone/Fax

Practice location:
  • Phone: 718-769-9001
  • Fax:
Mailing address:
  • Phone: 718-769-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number247810
License Number StateNY

VIII. Authorized Official

Name: DR. KHALED OSMAN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 718-769-9001