Kai Ayana Baltimore
Individual provider Active NPI Contractor · Bronx, NY
NPI 1770834624 · NPPES record last updated Oct 1, 2012
Key facts
- NPI
- 1770834624
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 857321 (NY)
- Practice address
- 2510 Westchester Ave RM 102
Bronx, NY 10461-3512 - Phone
- (718) 597-5558
- NPI assigned
- Oct 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 857321 | NY | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theracare | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 857321 | NY | Yes |
Addresses
Primary practice location
2510 Westchester Ave RM 102
Bronx, NY 10461-3512
Mailing address
37 Featherbed LN Apt 5D
Bronx, NY 10452-1641
Phone (347) 269-8291
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.