Provider Demographics
NPI:1649059528
Name:CKKB INC
Entity type:Organization
Organization Name:CKKB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISHEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BELFON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-637-6414
Mailing Address - Street 1:1441 WOODMONT LN NW # 2298
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2866
Mailing Address - Country:US
Mailing Address - Phone:516-637-6414
Mailing Address - Fax:
Practice Address - Street 1:1441 WOODMONT LN NW # 2298
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2866
Practice Address - Country:US
Practice Address - Phone:516-637-6414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier