Provider Demographics
NPI:1417421728
Name:HTYTE, KYAW (MBBS, MPH, PHD, MBA)
Entity Type:Individual
Prefix:DR
First Name:KYAW
Middle Name:
Last Name:HTYTE
Suffix:
Gender:M
Credentials:MBBS, MPH, PHD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2273 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4415
Mailing Address - Country:US
Mailing Address - Phone:917-913-4005
Mailing Address - Fax:
Practice Address - Street 1:115 BROADWAY STE 1800
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1652
Practice Address - Country:US
Practice Address - Phone:917-913-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAEE-17-11293207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAEE-17-11293OtherAESTHETIC LICENSE