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Individual

VICHAI LOTONGKHUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
361 STOCKHOLM ST, BROOKLYN, NY 11237-4025
(718) 381-2121
(718) 497-0740
Mailing address
361 STOCKHOLM ST, BROOKLYN, NY 11237-4025
(718) 381-2121
(718) 497-0740

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
127806
NY
207RC0000X
Cardiovascular Disease Physician
Primary
127806
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00237334
NY
01
P418016
OXFORD
NY
Enumeration date
05/31/2006
Last updated
01/05/2010
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