Kings Bay Medical Health P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

260048 Issued in NY

Legal business name

KINGS BAY MEDICAL HEALTH P.C.

Practice address

2069 2ND Ave
New York, NY 10029-4101

Phone

(212) 427-2200

NPI assigned

Jun 18, 2015

Organization subpart

No

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

Authorized official

Name

Dmitry Ilyevsky, MD

Title

Medical Director

Phone

(212) 427-2200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1184006850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2069 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-427-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2069 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-427-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS BAY MEDICAL HEALTH P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "ILYEVSKY",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-427-2200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "260048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly J Kingdon, PHD
• T Peter Kingham, M.D.
• Natalie Dee Kinghorn, P.T.
• Sydney Kingman, RPA-C
• Kings and Queens Optometry P.C. (Empire Eye Care)
• Kings County Plastic Surgery Services, P.C.
• Kings Park Slope LLC (Prima)
• Kings Third Ave. Pharmacy LLC (Kings Pharmacy)
• Kings Tribeca Phamacy Inc
• Laneice S Kingsberry

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.