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1083700926
PUNYADECH PHOTANGTHAM
NEW YORK, NY
NPI
1083700926
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 211187)
Enumeration Date
2006-10-05
Last Update Date
2015-12-02
Business Address
-- PUNYADECH PHOTANGTHAM MD
3875 BROADWAY UNIT B
NEW YORK, NY 10032-1567
Phone number: 212-543-3110
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Mailing Address
-- PUNYADECH PHOTANGTHAM MD
125 W 56TH ST #2B
NEW YORK, NY 10019-3807
Phone number: 212-247-7039
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