Individual
CHAIYAPORN KULSAKDINUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MT KISCO MEDICAL GROUP PC, 90 SOUTH BEDFORD ROAD, MOUNT KISCO, NY 10549-3412
(914) 241-1050
(914) 242-1516
Mailing address
MT KISCO MEDICAL GROUP PC, 90 SOUTH BEDFORD ROAD, MOUNT KISCO, NY 10549-3412
(914) 241-1050
(914) 242-1516
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
211185
NY
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
211185
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01978349
—
NY
01
—
133544120
TAX ID
NY
Enumeration date
05/18/2006
Last updated
10/14/2011
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