Individual
DR. JOHN L KEFALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 SUNRISE HWY, SUITE 200, LYNBROOK, NY 11563-2950
(516) 887-3516
(516) 887-0331
Mailing address
777 SUNRISE HWY, SUITE 200, LYNBROOK, NY 11563-2950
(516) 887-3516
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
152638
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000056378
GHI HMO
NY
05
—
01572861
—
NY
01
—
112573413
CCN,CHO HUM,FRSTHELTH,HOR
NY
01
—
152638
HIP
NY
01
—
1917532005
CIGNA
NY
01
—
3099813
GHI
NY
01
—
613
VYTRA
NY
01
—
62259790
MULTIPLAN
NY
01
—
640026
HEALTHCARE PARTNERS
NY
01
—
68866
PHCS
NY
01
—
AD00676
MDNY
NY
01
—
AS1069
OXFORD
NY
01
—
CPNN1526383
WORKERS COMP NO FAULT
NY
01
—
NS0001847
SELECT PRO
NY
01
—
OC3470
HEALTHNET
NY
Enumeration date
11/03/2005
Last updated
05/19/2022
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