Provider Demographics
NPI:1932391141
Name:KYLE KATO, M.D., MEDICAL PRACTICE, P.C.
Entity Type:Organization
Organization Name:KYLE KATO, M.D., MEDICAL PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-319-1511
Mailing Address - Street 1:65 W 55TH ST
Mailing Address - Street 2:4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4913
Mailing Address - Country:US
Mailing Address - Phone:212-319-1511
Mailing Address - Fax:917-421-9611
Practice Address - Street 1:65 W 55TH ST
Practice Address - Street 2:4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4913
Practice Address - Country:US
Practice Address - Phone:212-319-1511
Practice Address - Fax:212-769-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1919482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1366419947OtherBC & BS
NYP798171OtherOXFORD
NYP798171OtherOXFORD
NY74H691Medicare UPIN