MEDICARE: OHNMA KYAW NP

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	363L00000X	Nurse Practitioner	F303347	NY

General Provider Information

NPI Number	:	1700923695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OHNMA KYAW NP

Provider Business Mailing Address
First Line	:	760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230
Second Line	:	WOODHULL MEDICAL & MENTAL HEALTH CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11206
Country	:	US
Telephone Number	:	718-963-8000
Fax Number	:	718-630-3122

Provider Business Practice Location Address
First Line	:	760 BROADWAY
Second Line	:	WOODHULL MEDICAL & MENTAL HEALTH CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11206
Country	:	US
Telephone Number	:	718-963-8000
Fax Number	:	718-871-7581

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2014

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