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General NPI Number Information
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NPI Number | 1366252330
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Entity Type | Organization
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Legal Business Name | KS MEDICAL CARE PC
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 60 QUEENS STREET STE 100
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City | SYOSSET
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State | NY
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Zip | 11791-3058
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Country | US
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Telephone | 631-271-9151
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Fax | 631-271-9155
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Provider Business Mailing Address
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Address Line | 60 QUEENS STREET STE 100
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City | SYOSSET
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State | NY
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Zip | 11791-3058
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Country | US
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Telephone | 631-271-9151
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Fax | 631-271-9155
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Authorized Official
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Title or Position | CO-OWNER
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Name | ALEKSANDER SHALSHIN
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Credential | MD
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Telephone | 631-271-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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