Provider Demographics
NPI:1932431392
Name:KYI, SCOTT G
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:G
Last Name:KYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6301
Mailing Address - Country:US
Mailing Address - Phone:212-227-7262
Mailing Address - Fax:212-227-7242
Practice Address - Street 1:159 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6301
Practice Address - Country:US
Practice Address - Phone:212-227-7262
Practice Address - Fax:212-227-7242
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist