MEDICARE: KAI SUN

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	163WS0200X	School Registered Nurse	622089	NY

General Provider Information

NPI Number	:	1720583081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAI SUN

Provider Business Mailing Address
First Line	:	70 HAVEN AVE APT4B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032
Country	:	US
Telephone Number	:	212-740-5209
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 HAVEN AVE APT4B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1003
Country	:	US
Telephone Number	:	212-740-5209
Fax Number	:

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

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	03/28/2018

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Directions to “ KAI SUN ” Practice Location

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