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
1001 FRANKLIN AVE RM 110, GARDEN CITY, NY 11530-2901
(516) 396-7846
(516) 281-7417
Mailing address
2000 MARCUS AVE, NEW HYDE PARK, NY 11042-1069
(516) 396-7846
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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