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General NPI Number Information
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NPI Number | 1245791086
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Entity Type | Organization
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Legal Business Name | NY QUEENS NP ADULT HEALTH CARE PC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 3819 UNION ST STE 204
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City | FLUSHING
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State | NY
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Zip | 11354-5588
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Country | US
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Telephone | 347-368-6691
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Fax | 929-999-5729
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Provider Business Mailing Address
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Address Line | 351 HERRICKS RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3724
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Country | US
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Telephone | 347-368-6691
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YUNKYOUNG JEONG
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Credential | NP
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Telephone | 347-368-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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