Provider Demographics
NPI:1053640722
Name:WIN, SEIN (MD)
Entity Type:Individual
Prefix:
First Name:SEIN
Middle Name:
Last Name:WIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 41ST ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3901
Mailing Address - Country:US
Mailing Address - Phone:347-229-4969
Mailing Address - Fax:212-226-1613
Practice Address - Street 1:98 E BROADWAY FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7181
Practice Address - Country:US
Practice Address - Phone:212-227-4349
Practice Address - Fax:212-226-1613
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03175064Medicaid