Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 154996 | NY |
NPI | 1003804337 |
---|---|
Provider Name | Michael M Kyi |
First Address | South Salem, NY 10590-2018 |
Second Address | Sleepy Hollow, NY 10591-1020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1082151 | AETNA HMO-NWH (01) | NY |
1767Q1 | BCBS PIN # (01) | NY |
4147736 | MVP PIN#-NWH (01) | |
7199210 | AETNA PPO - NWH (01) | NY |
A98620 | (02) |