Provider Demographics
NPI:1780843938
Name:LWIN, NYO (MD)
Entity Type:Individual
Prefix:
First Name:NYO
Middle Name:
Last Name:LWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 JORALEMON ST
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4356
Mailing Address - Country:US
Mailing Address - Phone:646-962-4600
Mailing Address - Fax:718-852-7007
Practice Address - Street 1:186 JORALEMON ST
Practice Address - Street 2:11TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4356
Practice Address - Country:US
Practice Address - Phone:646-962-4600
Practice Address - Fax:718-852-7007
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY253768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03125688Medicaid
NYA400014596Medicare PIN