Provider Demographics
NPI:1528159829
Name:KILION, DAPHNA (MD)
Entity type:Individual
Prefix:
First Name:DAPHNA
Middle Name:
Last Name:KILION
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 1:444 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-475-5250
Mailing Address - Fax:631-475-9536
Practice Address - Street 1:444 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-475-5250
Practice Address - Fax:631-475-9536
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177438207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01287681Medicaid
E94732Medicare UPIN
89F001Medicare ID - Type Unspecified