| Phoenix Medical Office Pllc | |
|
5223 Van Loon St Elmhurst NY 11373-4258 | |
| (646) 943-1588 | |
| Not Available |
| Full Name | Phoenix Medical Office Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5223 Van Loon St, Elmhurst, New York |
| Authorized Official Name and Position | Kyawt Thandar Aung (PRESIDENT) |
| Authorized Official Contact | 6469431588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Medical Office Pllc 19614 58th Ave # 1f Fresh Meadows NY 11365-2306 Ph: (646) 943-1588 | Phoenix Medical Office Pllc 5223 Van Loon St Elmhurst NY 11373-4258 Ph: (646) 943-1588 |
| NPI Number | 1770919466 |
|---|---|
| Provider Enumeration Date | 09/25/2013 |
| Last Update Date | 09/25/2013 |
| Medicare PECOS PAC ID | 5496984726 |
|---|---|
| Medicare Enrollment ID | O20140210000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770919466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 241558 (New York) | Primary |
| Provider Name | Kyawt T Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548424963 PECOS PAC ID: 2860560075 Enrollment ID: I20081001000186 |
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