Kormylo, Edward J
Kormylo, Edward J is an sole proprietor health care provider with primary practice located at 33 Medford Ave Ste D , Patchogue NY 11772-1222. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Kormylo, Edward J can be contacted via phone (631) 687-4190.Contact Information
Primary practice address
33 Medford Ave Ste D
Patchogue NY 11772-1222
Phone: (631) 687-4190
Fax: (631) 687-4199
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | N003100 | New York |
Profile Details
| NPI number | 1568436392 |
|---|---|
| LBN Legal business name | Kormylo, Edward J |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Oct 28th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568436392 | NPPES |
| New York | Other | 480015120 | MEDICARE RAILROAD |
| New York | MEDICAID | 00588743 | MEDICARE RAILROAD |
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