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General NPI Number Information
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NPI Number | 1427691286
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Entity Type | Organization
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Legal Business Name | KV MEDICAL OF NY PC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 1065 OLD COUNTRY RD
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City | WESTBURY
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State | NY
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Zip | 11590-5640
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Country | US
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Telephone | 347-878-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 21315 33RD RD
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City | BAYSIDE
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State | NY
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Zip | 11361-1508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KETAN D. VORA
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Credential |
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Telephone | 347-878-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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