Provider Demographics
NPI:1679324438
Name:KO MEDICAL REHABILITATION, PLLC
Entity type:Organization
Organization Name:KO MEDICAL REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KUNAL
Authorized Official - Middle Name:
Authorized Official - Last Name:OAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-598-6808
Mailing Address - Street 1:43 NARCISSUS DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2820
Mailing Address - Country:US
Mailing Address - Phone:718-598-6808
Mailing Address - Fax:770-502-6792
Practice Address - Street 1:888 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4914
Practice Address - Country:US
Practice Address - Phone:718-598-6808
Practice Address - Fax:770-502-6792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty