Active NPI
Mun Yee Kwan, PHD
- Clinical Psychologist
- Jericho, NY
National Provider Identifier
1881435493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025504-01
- Practice address
- 500 N Broadway Ste 215
Jericho, NY 11753-2145 - Phone
- (516) 719-6383
- NPI assigned
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 025504-01 | NY | Primary |
Addresses
Primary practice location
500 N Broadway Ste 215
Jericho, NY 11753-2145
Mailing address
541 Emerson Ave
North Baldwin, NY 11510-2205
Phone (701) 936-0915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025504-01 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1881435493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 EMERSON AVE",
"city": "NORTH BALDWIN",
"state": "NY",
"postal_code": "115102205",
"telephone_number": "701-936-0915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N BROADWAY STE 215",
"city": "JERICHO",
"state": "NY",
"postal_code": "117532145",
"telephone_number": "516-719-6383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "MUN YEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-06",
"last_updated": "2024-06-06",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025504-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jericho, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.