Healthcare Provider Details

I. General information

NPI: 1043319973
Provider Name (Legal Business Name): TINA MU-HSIN KUO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TINA KUO M.D.

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42-02 KISSENA BLVD. #1A
FLUSHING NY
11355
US

IV. Provider business mailing address

42-02 KISSENA BLVD. #1A
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-939-8085
  • Fax: 718-939-8087
Mailing address:
  • Phone: 718-939-8085
  • Fax: 718-939-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number208061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: