MGK Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

129466689 Issued in NY

Legal business name

MGK INC

Practice address

66 Summer St Unit 311
Stamford, CT 06901-2316

Phone

(917) 504-2705

Fax

(203) 428-6200

NPI assigned

Aug 17, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Michael Gerard Kudrenetsky, MSEDNPI 1164853842

Title

President

Phone

(917) 504-2705

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Gerard Kudrenetsky, M.S.E.D.

  • Specialist
  • Yonkers, NY
  • NPI 1164853842
  NPD (past) Authorized official

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502928000000",
    "number": "1245756733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104690701",
            "telephone_number": "917-504-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SUMMER ST UNIT 311",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012316",
            "telephone_number": "917-504-2705",
            "fax_number": "203-428-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "status": "A",
        "authorized_official_last_name": "KUDRENETSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-504-2705",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "129466689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164853842",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lois B. Meyer, LMSW
• Dmitry Meyerovich, M.D.
• Katharine Meyers, M.D.
• Leon Meytin, MD
• Lynda P. Mezansky, MS,RD,CDN
• MH Health Care Services, PC
• MH Health Care Services, PC
• Ranjeeta Mhatre
• Michael B. Stein, DMD, PC
• Malgorzata Michalowska-Suterska

• Early Intervention Provider Agency in Stamford, CT
• Providers in Stamford, CT by specialty
• Early Intervention Provider Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.