Provider Demographics
NPI:1407237506
Name:CHANDHANAYINGYONG, CHANDHANARAT (MD)
Entity Type:Individual
Prefix:
First Name:CHANDHANARAT
Middle Name:
Last Name:CHANDHANAYINGYONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MAIN ST
Mailing Address - Street 2:APT 9M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0085
Mailing Address - Country:US
Mailing Address - Phone:917-862-0442
Mailing Address - Fax:
Practice Address - Street 1:475 MAIN ST
Practice Address - Street 2:APT 9M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0085
Practice Address - Country:US
Practice Address - Phone:917-862-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program