Basic Information
| Provider Information | |||||||||
| NPI: | 1629308630 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WIN | ||||||||
| FirstName: | THANDAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 707 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109402650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453331114 | ||||||||
| FaxNumber: | 8453331102 | ||||||||
| Practice Location | |||||||||
| Address1: | 68 HARRIS BUSHVILLE RD | ||||||||
| Address2: | |||||||||
| City: | HARRIS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457917828 | ||||||||
| FaxNumber: | 8457943347 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2010 | ||||||||
| LastUpdateDate: | 01/15/2016 | ||||||||
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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 | 2084P0800X | 269449 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.