Provider Demographics
NPI:1336551795
Name:PYKE, OWEN JOSEPH
Entity type:Individual
Prefix:
First Name:OWEN
Middle Name:JOSEPH
Last Name:PYKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 STEWART AVENUE STE. 200
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-1430
Mailing Address - Fax:
Practice Address - Street 1:700 STEWART AVE STE 200
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4726
Practice Address - Country:US
Practice Address - Phone:516-663-1430
Practice Address - Fax:516-222-2442
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296894208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery