Provider Demographics
NPI:1396053104
Name:SIGLOS, KAY BAEL (MD)
Entity type:Individual
Prefix:MISS
First Name:KAY
Middle Name:BAEL
Last Name:SIGLOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5165 CODWISE PL
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4148
Mailing Address - Country:US
Mailing Address - Phone:917-969-3162
Mailing Address - Fax:
Practice Address - Street 1:339 E 77TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-2250
Practice Address - Country:US
Practice Address - Phone:917-969-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029374225100000X
390200000X
CT72834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program