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General NPI Number Information
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NPI Number | 1063358893
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Entity Type | Organization
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Legal Business Name | RKMAA REHABILITATION MEDICAL
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 140 BEACH 113TH ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2403
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Country | US
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Telephone | 718-945-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 149 E 23RD ST # 1816
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City | NEW YORK
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State | NY
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Zip | 10010-3765
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Country | US
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Telephone | 718-945-6350
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ROBERT KAYLAKOV
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Credential | MD
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Telephone | 646-339-4059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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