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NPI Code Detail

MEDICARE: JENNIFER KYKO DO

MEDICARE: JENNIFER KYKO DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538004890
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KYKO DO
Provider Business Mailing Address
First Line : 4201 SAINT ANTOINE ST
Second Line : UHC 9C
City : DETROIT
State : MI
Zip : 48201-2153
Country : US
Telephone Number : 313-745-5146
Fax Number : 313-966-0880
Provider Business Practice Location Address
First Line : 4201 SAINT ANTOINE ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2153
Country : US
Telephone Number : 313-745-5146
Fax Number : 313-966-0880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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