| Kanghan Medical Services, P.c. | |
|
19214 Northern Blvd Ste 2d Flushing NY 11358-2955 | |
| (718) 762-3240 | |
| Not Available |
| Full Name | Kanghan Medical Services, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 19214 Northern Blvd Ste 2d, Flushing, New York |
| Authorized Official Name and Position | Byung C Kang (PRESIDENT) |
| Authorized Official Contact | 7187623240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kanghan Medical Services, P.c. 38-34 Parsons Blvd. Suite# 1a Flushing NY 11354-6126 Ph: (718) 762-3240 | Kanghan Medical Services, P.c. 19214 Northern Blvd Ste 2d Flushing NY 11358-2955 Ph: (718) 762-3240 |
| NPI Number | 1356553549 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 6305862715 |
|---|---|
| Medicare Enrollment ID | O20051102001184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356553549 | NPI | - | NPPES |
| 02245623 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 219561 (New York) | Primary |
| Provider Name | Byung Kang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760484687 PECOS PAC ID: 1456377878 Enrollment ID: I20051104000553 |
| Provider Name | Jieun Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154580843 PECOS PAC ID: 6507156759 Enrollment ID: I20160810000728 |
| Provider Name | Eunmyung Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538555743 PECOS PAC ID: 1759658750 Enrollment ID: I20170526001034 |
| Provider Name | Jacob David Leigh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134576010 PECOS PAC ID: 4082941497 Enrollment ID: I20190808000173 |
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