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General NPI Number Information
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NPI Number | 1861792780
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Entity Type | Organization
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Legal Business Name | K I MEDICAL PC
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 11909 METROPOLITAN AVE
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City | KEW GARDENS
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State | NY
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Zip | 11415-2605
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Country | US
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Telephone | 718-850-1414
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Fax | 718-850-5025
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Provider Business Mailing Address
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Address Line | 118 82 METROPOLITAN AVE 1B
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 718-850-1414
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Fax | 718-850-5025
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Authorized Official
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Title or Position | D O
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Name | DR. INNA KIGEL
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Credential |
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Telephone | 718-850-1414
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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 | 219691
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License Number State | NY
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