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Organization
MOUNT KISCO MEDICAL GROUP PC
Active
Organization
MOUNT KISCO MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MONACO (BILLING DIRECTOR)
(914) 241-1050
Entity
Organization
Contact information
Practice address
1940 COMMERCE ST, SUITE 201, YORKTOWN HTS, NY 10598-4428
(914) 962-5577
Mailing address
90 S BEDFORD RD, MOUNT KISCO, NY 10549-3412
(914) 241-1050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00547351
—
NY
Enumeration date
04/26/2007
Last updated
08/22/2020
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