Provider Demographics
NPI:1275737686
Name:KINGS HIGHWAY BEST MEDICAL PC
Entity Type:Organization
Organization Name:KINGS HIGHWAY BEST MEDICAL PC
Other - Org Name:OLGA TSEYKO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSEYKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-873-7466
Mailing Address - Street 1:127 JAFFREY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3022
Mailing Address - Country:US
Mailing Address - Phone:718-382-8282
Mailing Address - Fax:718-946-7964
Practice Address - Street 1:1421 CARROLL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4449
Practice Address - Country:US
Practice Address - Phone:347-627-9107
Practice Address - Fax:341-405-9108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221645261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWWR811OtherMEDICARE GROUP NUMBER
NYH47660Medicare UPIN
NY36V29WR811Medicare PIN