Healthcare Provider Details
I. General information
NPI: 1841635331
Provider Name (Legal Business Name): RKD MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2013
Last Update Date: 05/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
405 5TH AVE
BROOKLYN NY
11215-3315
US
IV. Provider business mailing address
2637 E 6TH ST
BROOKLYN NY
11235-6208
US
V. Phone/Fax
- Phone: 718-222-5999
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABUL
KASHEM
Title or Position: TREASURER
Credential:
Phone: 718-222-5999