OrganizationKings Bay Medical Health P.C.Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address2069 2nd Ave, New York, NY 10029-4101(212) 427-2200PECOS EnrollmentBased on the most recent information from CMS, provider Kings Bay Medical Health P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1184006850Provider TypeOrganizationFull NameKings Bay Medical Health P.C.SubpartNoEnumeration Date6/18/2015Last Updated6/18/2015Contact InformationPractice LocationPractice Address2069 2nd Ave, New York, NY 10029-4101Phone(212) 427-2200FaxUnlisted FaxMailing LocationMailing Address2069 2nd Ave, New York, NY 10029-4101Phone(212) 427-2200FaxUnlisted FaxAuthorized OfficialNameIlyevsky, Dmitry (Medical Director)Phone(212) 427-2200Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense260048New York