Individual
IYAVUT THAIPISUTTIKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-8011
Mailing address
1233 YORK AVE APT 15O, NEW YORK, NY 10065-6342
(314) 761-3313
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD440204
PA
2084N0400X
Neurology Physician
P76343
NY
Other
Enumeration date
06/19/2007
Last updated
03/13/2011
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