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NPI Code Detail

MEDICARE: THAN THAN AYE MD

MEDICARE: THAN THAN AYE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician151420-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083611537
Entity Type Code : Individual
Provider Name (Legal Business Name) : THAN THAN AYE MD
Provider Business Mailing Address
First Line : PO BOX 10049
Second Line :
City : NEW YORK
State : NY
Zip : 10259-0049
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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Directions to “ THAN THAN AYE MD” Practice Location

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