Eric Kane, MD

Individual provider Active NPI Orthopaedic Surgery Physician · Bayport, NY

NPI 1104078401 · NPPES record last updated Oct 17, 2008

Key facts

NPI
1104078401
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
096869 (NY)
Practice address
47 Gillette Ave
Bayport, NY 11705-1839
Phone
(631) 472-3411
NPI assigned
Oct 17, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20141016000003 NY Order and Referring Only - Orthopedic Surgery
Practitioner - Orthopedic Surgery
2365663366

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
096869NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 096869 NY Yes

Addresses

Primary practice location

47 Gillette Ave
Bayport, NY 11705-1839

Mailing address

47 Gillette Ave
Bayport, NY 11705-1839
Phone (631) 472-3411

Other providers in Bayport, NY

All providers in Bayport, NY · Orthopaedic Surgery Physician in New York

Sources for this page

Verify at the official NPI Registry.