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Individual

CHIN THAPVONGSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1269 GRAND CONCOURSE, BRONX, NY 10452
(718) 293-3424
(718) 293-3424
Mailing address
28 BIRCHDALE LANE, PORT WASHINGTON, NY 10050-4502
(516) 627-2505

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
133396
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00439978
NY
Enumeration date
11/27/2006
Last updated
07/08/2007
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