MEDICARE: KINGSWAY ORTHOPEDIC PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	173063	NY

General Provider Information

NPI Number	:	1033219951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINGSWAY ORTHOPEDIC PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3156 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2616
Country	:	US
Telephone Number	:	718-252-7324
Fax Number	:	718-951-7371

Provider Business Practice Location Address
First Line	:	3156 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2616
Country	:	US
Telephone Number	:	718-252-7324
Fax Number	:	718-951-7371

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIC SENAT
Credential	:	M.D.
Telephone Number	:	718-252-7324

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	02/18/2009

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Directions to “KINGSWAY ORTHOPEDIC PROFESSIONAL CORPORATION ” Practice Location

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