| Myung Gastroenterology, P.c. | |
|
15408 Northern Blvd Suite 2k Flushing NY 11354-5040 | |
| (718) 445-0200 | |
| Not Available |
| Full Name | Myung Gastroenterology, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 15408 Northern Blvd, Flushing, New York |
| Authorized Official Name and Position | Joon Mo Myung (OWNER) |
| Authorized Official Contact | 7184450200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myung Gastroenterology, P.c. 15408 Northern Blvd Suite 2k Flushing NY 11354-5040 Ph: (718) 445-0200 | Myung Gastroenterology, P.c. 15408 Northern Blvd Suite 2k Flushing NY 11354-5040 Ph: (718) 445-0200 |
| NPI Number | 1619271897 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 5890979181 |
|---|---|
| Medicare Enrollment ID | O20110412000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619271897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 256592-1 (New York) | Primary |
| Provider Name | Liying O Han |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1750502589 PECOS PAC ID: 6507952595 Enrollment ID: I20071023000082 |
| Provider Name | Joon Mo Myung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265598759 PECOS PAC ID: 7113997008 Enrollment ID: I20110412000045 |
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