Provider Demographics
NPI:1164040200
Name:SRKITE ASSOCIATES
Entity Type:Organization
Organization Name:SRKITE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:ROBERTA
Authorized Official - Last Name:KITE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-204-2421
Mailing Address - Street 1:9532 BRANCHLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2000
Mailing Address - Country:US
Mailing Address - Phone:443-204-2421
Mailing Address - Fax:
Practice Address - Street 1:8 SUDBROOK LN STE 1A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4132
Practice Address - Country:US
Practice Address - Phone:443-405-2564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty