Provider Demographics
NPI:1992850895
Name:KMRC, LLC
Entity Type:Organization
Organization Name:KMRC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:LAMBRAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MDFACS
Authorized Official - Phone:718-297-4300
Mailing Address - Street 1:175-61 HILLSIDE AVENUE 4TH FLOOR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:718-297-4300
Mailing Address - Fax:
Practice Address - Street 1:175-61 HILLSIDE AVENUE 4TH FLOOR
Practice Address - Street 2:SUITE 400
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-297-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy