Provider Demographics
NPI:1427095686
Name:YU, KYI WIN (MD)
Entity type:Individual
Prefix:DR
First Name:KYI
Middle Name:WIN
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6403 213TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2128
Mailing Address - Country:US
Mailing Address - Phone:718-428-0282
Mailing Address - Fax:718-428-1603
Practice Address - Street 1:8704A ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1610
Practice Address - Country:US
Practice Address - Phone:718-945-6500
Practice Address - Fax:718-945-6509
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01749682Medicaid
NYG48144Medicare UPIN
NY0026VDMedicare ID - Type Unspecified
NY01749682Medicaid