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General NPI Number Information
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NPI Number | 1174628945
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Entity Type | Organization
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Legal Business Name | SOMSAK BHITIYAKUL, M.D., P.C.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 368 BROADWAY SUITE 201
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City | KINGSTON
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State | NY
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Zip | 12401-5160
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Country | US
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Telephone | 845-339-5811
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Fax | 845-339-0708
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Provider Business Mailing Address
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Address Line | 368 BROADWAY SUITE 201
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City | KINGSTON
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State | NY
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Zip | 12401-5160
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Country | US
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Telephone | 845-339-5811
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Fax | 845-339-0708
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Authorized Official
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Title or Position | OWNER
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Name | DR. SOMSAK BHITIYAKUL
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Credential | M.D.
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Telephone | 845-339-5811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 111158
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 224184
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License Number State | NY
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