Organization
MYO THANT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYO THANT MD (OWNER)
(718) 361-6038
Entity
Organization
Contact information
Practice address
8605 51ST AVE, ELMHURST, NY 11373-3921
(718) 361-6038
Mailing address
8605 51ST AVE, ELMHURST, NY 11373-3921
(718) 361-6038
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
212485
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02190178
—
NY
Enumeration date
02/01/2016
Last updated
02/01/2016
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