MEDICARE: KINGS MEDICAL GROUP PC

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	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician

General Provider Information

NPI Number	:	1457223596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINGS MEDICAL GROUP PC

Provider Business Mailing Address
First Line	:	7620 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7620 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1532
Country	:	US
Telephone Number	:	347-884-1540
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ALEXANDR DRON
Credential	:
Telephone Number	:	347-884-1540

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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Directions to “KINGS MEDICAL GROUP PC ” Practice Location

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