Im, Wichae
Im, Wichae is an individual health care provider with primary practice located at 7901 Broadway Room A1-9, Elmhurst NY 11373-1329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Im, Wichae can be contacted via phone (718) 334-4952.Contact Information
Primary practice address
7901 Broadway Room A1-9
Elmhurst NY 11373-1329
Phone: (718) 334-4952
Fax: (718) 334-4815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 198358 | New York |
Profile Details
| NPI number | 1558398214 |
|---|---|
| LBN Legal business name | Im, Wichae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Dec 10th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558398214 | NPPES |
| New York | MEDICAID | 01862922 |
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