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General NPI Number Information
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NPI Number | 1417371774
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Entity Type | Organization
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Legal Business Name | MKR MEDICAL PC
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 828 UTICA AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-3409
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Country | US
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Telephone | 718-303-0851
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Fax |
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Provider Business Mailing Address
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Address Line | 545 E JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7325
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Country | US
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Telephone | 718-303-0851
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARC RYBSTEIN
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Credential | MD
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Telephone | 516-307-9618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 253288
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 253288
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License Number State | NY
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