Organization Name: | ETK RPA, PC |
NPI Number: | 1265488027 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EUGENE T KING (PRESIDENT) |
Mailing Address: | 19 Fox Trail Court Aquebogue |
State: | NY US |
Postal Code: | 119310083 |
Phone Number: | 6317666538 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 001662 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |