Provider Demographics
NPI:1679598502
Name:KML MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:KML MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIHAELA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GALICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-254-1182
Mailing Address - Street 1:60 GRAMERCY PARK NORTH
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5429
Mailing Address - Country:US
Mailing Address - Phone:212-254-1220
Mailing Address - Fax:212-254-1387
Practice Address - Street 1:60 GRAMERCY PARK NORTH
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5429
Practice Address - Country:US
Practice Address - Phone:212-254-1220
Practice Address - Fax:212-254-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02689467Medicaid
NY02689467Medicaid
NYWAW251Medicare PIN