Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Punyadech Photangtham, MD

Individual provider Family Medicine Physician · NPI 1083700926

Punyadech Photangtham, MD is a Family Practice in New York, New York. Graduated from George Washington University School of Medicine in 1996, 30 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
30
Trained at
George Washington University School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3875 Broadway Unit B
New York, NY 10032-1567
Phone: (212) 543-3110
Fax: (212) 543-3111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 211187 (NY)

Record details

NPI number1083700926
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 5, 2006
Last updated in NPPESDecember 2, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolGEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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