Provider Demographics
NPI:1659458685
Name:KINGS HIGHWAY ORTHOPEDIC ASSOC PC
Entity Type:Organization
Organization Name:KINGS HIGHWAY ORTHOPEDIC ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-258-2588
Mailing Address - Street 1:1715 E 13TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1901
Mailing Address - Country:US
Mailing Address - Phone:718-258-2588
Mailing Address - Fax:718-258-2205
Practice Address - Street 1:1715 E 13TH ST # 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1901
Practice Address - Country:US
Practice Address - Phone:718-258-2588
Practice Address - Fax:718-258-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1659458685OtherNPI
NY1659458685OtherNPI
NY0781070001Medicare NSC