Provider Demographics
NPI:1316135882
Name:KEVIN WRIGHT MD PC
Entity type:Organization
Organization Name:KEVIN WRIGHT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-336-0766
Mailing Address - Street 1:51 E 25TH ST
Mailing Address - Street 2:6TH FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2945
Mailing Address - Country:US
Mailing Address - Phone:212-336-0766
Mailing Address - Fax:212-696-0162
Practice Address - Street 1:51 - E 25TH STREET
Practice Address - Street 2:6TH FL
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-336-0766
Practice Address - Fax:212-696-0162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEVIN WRIGHT M.D. P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-10
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY665F0ZWPQ1Medicare PIN