Provider Demographics
NPI:1437557816
Name:LWIN, THIT (MSED)
Entity Type:Individual
Prefix:
First Name:THIT
Middle Name:
Last Name:LWIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 GEORGE ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5574
Mailing Address - Country:US
Mailing Address - Phone:347-623-8298
Mailing Address - Fax:
Practice Address - Street 1:1832 GEORGE ST APT 3A
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5574
Practice Address - Country:US
Practice Address - Phone:347-623-8298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY807326131252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency