Provider Demographics
NPI:1447244900
Name:MON, MYAT MYAT (MD)
Entity Type:Individual
Prefix:DR
First Name:MYAT MYAT
Middle Name:
Last Name:MON
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 1:86 BOWERY
Mailing Address - Street 2:SUITE 6FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4615
Mailing Address - Country:US
Mailing Address - Phone:646-288-3585
Mailing Address - Fax:212-244-6908
Practice Address - Street 1:86 BOWERY
Practice Address - Street 2:SUITE 6FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4615
Practice Address - Country:US
Practice Address - Phone:646-288-3585
Practice Address - Fax:212-244-6908
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207824208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02353717Medicaid
NY02353717Medicaid
H79344Medicare UPIN