Organization
WITTAYA PAYACKAPAN MD. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WITTAYA PAYACKAPAN M.D (PRESIDENT)
(631) 842-6626
Entity
Organization
Contact information
Practice address
365 BROADWAY, SUITE #5, AMITYVILLE, NY 11743
(631) 842-6626
(631) 842-6609
Mailing address
365 BROADWAY, SUITE #5, AMITYVILLE, NY 11743
(631) 842-6626
(631) 842-6609
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00349615
—
NY
Enumeration date
04/01/2009
Last updated
04/01/2009
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