Organization
MEDICAL SERVICES OF KIPS BAY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
825 NORTHERN BLVD STE 201, GREAT NECK, NY 11021-5323
(516) 773-7500
(516) 773-7575
Mailing address
2000 MARCUS AVE, NEW HYDE PARK, NY 11042-1069
(516) 773-7500
(516) 773-7575
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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