Provider Demographics
NPI:1437464922
Name:MAYA KUN MEDICAL P.C.
Entity Type:Organization
Organization Name:MAYA KUN MEDICAL P.C.
Other - Org Name:C.A.P.S. - CHILD AND ADOLESCENT PSYCHIATRIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-781-5163
Mailing Address - Street 1:2245 E 19TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4655
Mailing Address - Country:US
Mailing Address - Phone:718-781-5163
Mailing Address - Fax:646-558-0315
Practice Address - Street 1:95 PIERREPONT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2704
Practice Address - Country:US
Practice Address - Phone:718-755-0332
Practice Address - Fax:646-558-0315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2424912084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty