Provider Demographics
NPI:1538922414
Name:KINGS DIAGNOSTICS MEDICAL PC
Entity type:Organization
Organization Name:KINGS DIAGNOSTICS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:929-530-9298
Mailing Address - Street 1:250 AVENUE X FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5940
Mailing Address - Country:US
Mailing Address - Phone:347-922-5970
Mailing Address - Fax:
Practice Address - Street 1:2952 BRIGHTON 3RD ST STE 102
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7078
Practice Address - Country:US
Practice Address - Phone:929-530-9298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty