Kevin T Custis M D P C
LBN: Kevin T Custis M D P C
Kevin T Custis M D P C is an health care organization with primary practice located at 887 E New York Ave , Brooklyn NY 11203-1309. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Kevin T Custis M D P C can be contacted via phone (718) 778-0069, or through Custis, Kevin Tyrone via phone (718) 363-6675.
Contact Information
Primary practice address
887 E New York Ave
Brooklyn NY 11203-1309
Phone: (718) 778-0069
Fax: (718) 778-0035
Website:
Authorized official contact:
Name: Custis, Kevin Tyrone Doctor of Medicine (MD)
Phone: (718) 363-6675
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 211807 | New York |
Profile Details
| NPI number | 1376511881 |
|---|---|
| LBN Legal business name | Kevin T Custis M D P C |
| DBA Doing business as | |
| Authorized official | Custis, Kevin Tyrone Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 9th, 2006 |
| Last updated | Aug 6th, 2015 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376511881 | NPPES |
| New York | Other | 7505055 | AETNA US HEALTHCARE |
| New York | Other | 40 V182 | AETNA US HEALTHCARE |
| New York | Other | 6016214 | AETNA US HEALTHCARE |
| New York | MEDICAID | 01976654 | AETNA US HEALTHCARE |
| New York | Other | 40V183 | AETNA US HEALTHCARE |
| New York | Other | P2215900 | AETNA US HEALTHCARE |
| New York | Other | 211807 | AETNA US HEALTHCARE |
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