Healthcare Provider Details

I. General information

NPI: 1336880079
Provider Name (Legal Business Name): CHAN NYEIN HTET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554-1859
US

IV. Provider business mailing address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-4835
  • Fax: 516-572-5609
Mailing address:
  • Phone: 516-632-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number338218
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: