Provider Demographics
NPI:1235210956
Name:KIGEL, INNA (DO)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:KIGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11882 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2001
Mailing Address - Country:US
Mailing Address - Phone:718-850-1414
Mailing Address - Fax:717-850-5025
Practice Address - Street 1:11909 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2605
Practice Address - Country:US
Practice Address - Phone:718-850-1414
Practice Address - Fax:717-850-5025
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA219691-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02151444Medicaid
NYO4620Medicare ID - Type Unspecified
NY02151444Medicaid