Basic Information
| Provider Information | |||||||||
| NPI: | 1184911455 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KYAW | ||||||||
| FirstName: | MOE | ||||||||
| MiddleName: | TUN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1124 38TH ST | ||||||||
| Address2: | FL # 1 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112181927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502835299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 121 DEKALB AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112015425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182508000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2011 | ||||||||
| LastUpdateDate: | 07/07/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 60262057 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.