Provider Demographics
NPI:1801550611
Name:MEDINA SINGER, KENYA
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:MEDINA SINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24912 JERICHO TPKE STE 110
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-4020
Mailing Address - Country:US
Mailing Address - Phone:516-233-1717
Mailing Address - Fax:516-233-1715
Practice Address - Street 1:24912 JERICHO TPKE STE 110
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-4020
Practice Address - Country:US
Practice Address - Phone:516-233-1717
Practice Address - Fax:516-233-1715
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047721208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty