Provider Demographics
NPI:1881435493
Name:KWAN, MUN YEE (PHD)
Entity type:Individual
Prefix:DR
First Name:MUN YEE
Middle Name:
Last Name:KWAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2205
Mailing Address - Country:US
Mailing Address - Phone:701-936-0915
Mailing Address - Fax:
Practice Address - Street 1:500 N BROADWAY STE 215
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2145
Practice Address - Country:US
Practice Address - Phone:516-719-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025504-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical