MEDICARE: ALBERT DAEKI MIN 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
1	207RG0100X	Gastroenterology Physician	170352	NY
2	207RI0008X	Hepatology Physician	170352	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1396720256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT DAEKI MIN MD

Provider Business Mailing Address
First Line	:	1 GUSTAVE L LEVY PL # 1118
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6504
Country	:	US
Telephone Number	:	212-241-0896
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 UNION SQ E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-3314
Country	:	US
Telephone Number	:	212-420-4015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	08/01/2023

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