Healthcare Provider Details

I. General information

NPI: 1609942259
Provider Name (Legal Business Name): KWOK YUNG MIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BOWERY
NEW YORK NY
10002
US

IV. Provider business mailing address

6 QUAKER LANE
OLD WESTBURY NY
11568
US

V. Phone/Fax

Practice location:
  • Phone: 212-431-4333
  • Fax: 212-219-2823
Mailing address:
  • Phone: 212-431-4333
  • Fax: 212-219-2823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number118801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: