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NPI Code Detail

MEDICARE: NANWAI PAK M.D.

MEDICARE: NANWAI PAK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician172780NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396733531
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANWAI PAK M.D.
Provider Business Mailing Address
First Line : 150 55TH ST
Second Line : STATION 3-06
City : BROOKLYN
State : NY
Zip : 11220-2559
Country : US
Telephone Number : 718-630-6384
Fax Number : 718-630-7604
Provider Business Practice Location Address
First Line : 150 55TH ST
Second Line : STATION 3-06
City : BROOKLYN
State : NY
Zip : 11220-2559
Country : US
Telephone Number : 718-630-6384
Fax Number : 718-630-7604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 03/10/2021

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Directions to “ NANWAI PAK M.D.” Practice Location

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