=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639412877
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINGS COUNTY INFECTIOUS DISEASE P.C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2013
-----------------------------------------------------
Last Update Date | 04/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13621 ROOSEVELT AVE #1FL
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-922-0503
-----------------------------------------------------
Fax | 929-274-2868
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33 DAHLGREN PL
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11228-3503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-922-0503
-----------------------------------------------------
Fax | 929-274-2868
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ZEYAR THET
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 347-922-0503
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------