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General NPI Number Information
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NPI Number | 1174763809
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Entity Type | Individual
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Provider Name | WIROON SANGSIRAPRAPHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 82-70 164TH ST DEPARTMENT OF MEDICINE/ QUEENS HOSPITAL CENTER
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-883-4050
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Fax |
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Provider Business Mailing Address
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Address Line | 16410 84TH AVE APT 3G
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City | JAMAICA
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State | NY
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Zip | 11432-1826
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Country | US
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Telephone | 347-846-8702
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 874339
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License Number State | NY
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