King-Maceyko Dermatology Assoc LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KING-MACEYKO DERMATOLOGY ASSOC LTD

Practice address

350 Southmont Blvd
Johnstown, PA 15905-4330

Phone

(814) 536-7045

Fax

(814) 539-3927

NPI assigned

Sep 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra H King

Title

Practice Administrator

Phone

(814) 536-7045

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1023114642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SOUTHMONT BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-536-7045",
            "fax_number": "814-539-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SOUTHMONT BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-536-7045",
            "fax_number": "814-539-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING-MACEYKO DERMATOLOGY ASSOC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "814-536-7045"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "721126",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghaidaa Khlaifat, MD
• Adib Najib Khouzami, MD
• Andrea Kick, RN
• Tanya Lynn Kindel, PSY.D.
• Kindhearted Help Home Care
• Andrew Jordan King, MD
• Olivia Kathryn King, MOT, OTR/L
• Robyn King, DO
• Ashley Kisielewicz
• Bobbi Kisko, LCSW

• Dermatology Physician in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.