Provider Demographics
NPI:1356732374
Name:WINGTAT MUI MD PLLC
Entity type:Organization
Organization Name:WINGTAT MUI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MUI
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGTAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-796-2828
Mailing Address - Street 1:110 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3831
Mailing Address - Country:US
Mailing Address - Phone:212-796-2828
Mailing Address - Fax:
Practice Address - Street 1:81 ELIZABETH ST
Practice Address - Street 2:RM 601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4729
Practice Address - Country:US
Practice Address - Phone:212-796-2828
Practice Address - Fax:914-462-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty