Healthcare Provider Details

I. General information

NPI: 1184917445
Provider Name (Legal Business Name): CYRUS KAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 08/26/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523B WEAKLEY AVE
NASHVILLE TN
37207-5327
US

IV. Provider business mailing address

523B WEAKLEY AVE
NASHVILLE TN
37207-5327
US

V. Phone/Fax

Practice location:
  • Phone: 732-630-0581
  • Fax: 973-425-5663
Mailing address:
  • Phone: 732-630-0581
  • Fax: 973-425-5663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MA09710500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number278489
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA09710500
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number278489
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: