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Individual

TANABOON BHUPHAIBOOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 427-3700
(631) 427-1778
Mailing address
790 PARK AVE, HUNTINGTON, NY 11743-4516
(631) 427-3700
(631) 427-1778

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
11/16/2021
Last updated
11/16/2021
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