Mok, Ki-Tae

Mok, Ki-Tae is an individual health care provider with primary practice located at 47 New Scotland Ave , Albany NY 12208-3412. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Mok, Ki-Tae can be contacted via phone (518) 262-6279.

Contact Information

Primary practice address
47 New Scotland Ave Albany NY 12208-3412
Phone: (518) 262-6279
Fax: (518) 262-5718
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 227377 New York
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 227377 New York

Profile Details

NPI number 1366436230
LBN Legal business name Mok, Ki-Tae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated May 14th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366436230 NPPES
New York MEDICAID 02563091

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