Provider Demographics
NPI:1700084100
Name:KEVIN M TROY MD PC
Entity type:Organization
Organization Name:KEVIN M TROY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-860-9055
Mailing Address - Street 1:1735 YORK AVE
Mailing Address - Street 2:SUITE P2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6855
Mailing Address - Country:US
Mailing Address - Phone:212-860-9055
Mailing Address - Fax:212-348-0018
Practice Address - Street 1:1735 YORK AVE
Practice Address - Street 2:SUITE P2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6855
Practice Address - Country:US
Practice Address - Phone:212-860-9055
Practice Address - Fax:212-348-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY270831Medicare PIN
NY42D931Medicare PIN
NYB12016Medicare UPIN
NYB14393Medicare UPIN