Basic Information
| Provider Information | |||||||||
| NPI: | 1538391461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUI | ||||||||
| FirstName: | YAN CHUN | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2121 E 16TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112294401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186451058 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 WALKER ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122268866 | ||||||||
| FaxNumber: | 1212262289 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2009 | ||||||||
| LastUpdateDate: | 05/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 492568 | NY | N | Nursing Service Providers | Registered Nurse | 163WD0400X | 492568 | NY | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.