Provider Demographics
NPI:1467873018
Name:NK MEDICAL PC
Entity Type:Organization
Organization Name:NK MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEERU
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-281-4861
Mailing Address - Street 1:2 CORACI BLVD STE 11
Mailing Address - Street 2:WILLIAM FLOYD COMMONS
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-4833
Mailing Address - Country:US
Mailing Address - Phone:631-281-4861
Mailing Address - Fax:
Practice Address - Street 1:2 CORACI BLVD STE 11
Practice Address - Street 2:WILLIAM FLOYD COMMONS
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-4833
Practice Address - Country:US
Practice Address - Phone:631-281-4861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-29
Last Update Date:2013-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty