Provider Demographics
NPI:1316124837
Name:KHIN AUNG MEDICAL PC
Entity type:Organization
Organization Name:KHIN AUNG MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-672-3693
Mailing Address - Street 1:8708 JUSTICE AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4576
Mailing Address - Country:US
Mailing Address - Phone:718-672-3693
Mailing Address - Fax:718-672-3895
Practice Address - Street 1:8708 JUSTICE AVE APT 1N
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4576
Practice Address - Country:US
Practice Address - Phone:718-672-3693
Practice Address - Fax:718-672-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199745207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02952041Medicaid
NY01599811Medicaid
NY02952041Medicaid