Individual
KENJI C. MIYASAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 UNION SQ E, NEW YORK, NY 10003-3314
(212) 844-6750
(212) 844-6750
Mailing address
PO BOX 95000-2625, PHILADELPHIA, PA 19195-2625
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
199606
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01783393
—
NY
Enumeration date
06/14/2006
Last updated
10/08/2012
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