# OKSA MEDICAL PC

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

## Provider details

- **NPI number:** 1619900354
- **Authorized official:** DR. PAVEL KULIK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 396-1000

## Contact information

- **Practice address:** 9749 63RD DR, REGO PARK, NY 11374-2229
- **Practice address phone:** (718) 396-1000
- **Mailing address:** 9749 63RD DR, REGO PARK, NY 11374-2229
- **Mailing address phone:** (718) 396-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 228241 | NY | — |
| 207Y00000X | Otolaryngology Physician | 211012 | NY | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 224945 | NY | Yes |
| 208800000X | Urology Physician | 236385 | NY | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | N006031 | NY | — |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 10/27/2009