Provider Demographics
NPI:1932183258
Name:KIFLE, GETAHUN (MD)
Entity Type:Individual
Prefix:DR
First Name:GETAHUN
Middle Name:
Last Name:KIFLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 LINCOLN PLACE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-462-1100
Mailing Address - Fax:718-462-1900
Practice Address - Street 1:486 LINCOLN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6202
Practice Address - Country:US
Practice Address - Phone:718-463-1100
Practice Address - Fax:718-462-1900
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2093142081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01909351Medicaid
NYG75534Medicare UPIN
NY24Z251Medicare ID - Type Unspecified