# ETK RPA, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265488027
- **Authorized official:** EUGENE T KING (PRESIDENT)
- **Authorized official phone:** (631) 766-6538

## Contact information

- **Practice address:** 19 FOX TRAIL COURT, AQUEBOGUE, NY 11931-0083
- **Practice address phone:** (631) 766-6538
- **Mailing address:** PO BOX 83, AQUEBOGUE, NY 11931-0083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 001662 | NY | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 08/22/2020