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:
Map and Directions
Authorized official contact:
Name: Custis, Kevin Tyrone Doctor of Medicine (MD)
Phone: (718) 363-6675

Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
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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