Provider Demographics
NPI:1639460785
Name:KKS MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:KKS MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SALZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-366-6139
Mailing Address - Street 1:155 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5523
Mailing Address - Country:US
Mailing Address - Phone:914-366-6139
Mailing Address - Fax:
Practice Address - Street 1:155 WHITE PLAINS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5523
Practice Address - Country:US
Practice Address - Phone:914-366-6139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1517142086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty