Provider Demographics
NPI:1619465366
Name:TAI, ANDREW CHUN KEAT (ATC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHUN KEAT
Last Name:TAI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14712 BARCLAY AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1251
Mailing Address - Country:US
Mailing Address - Phone:646-206-3210
Mailing Address - Fax:
Practice Address - Street 1:14712 BARCLAY AVE FL 4
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1251
Practice Address - Country:US
Practice Address - Phone:646-206-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer