MEDICARE: WEYMIN HAGO MD

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
1	207R00000X	Internal Medicine Physician	258181	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1992941314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WEYMIN HAGO MD

Provider Business Mailing Address
First Line	:	3731 73RD ST
Second Line	:	APT 6F
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-6250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 PARK AVE S
Second Line	:	SUITE 202
City	:	NEW YORK
State	:	NY
Zip	:	10016-7320
Country	:	US
Telephone Number	:	646-688-3145
Fax Number	:	646-626-7555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	06/01/2016

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