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Individual

DR. EDWARD WILLIAM KOLK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
39 NEW HAMPSHIRE AVE, BAY SHORE, NY 11706-2507
(631) 273-4699
(631) 273-4699
Mailing address
39 NEW HAMPSHIRE AVE, BAY SHORE, NY 11706-2507
(631) 273-4699
(631) 273-4699

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
309257
NY
213E00000X
Podiatrist
Primary
N004109
NY

Other

Enumeration date
12/19/2006
Last updated
02/24/2011
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