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General NPI Number Information
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NPI Number | 1437379518
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Entity Type | Individual
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Provider Name | LAP PANG BENNY CHUNG RPA-C
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Gender | Male
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 08/07/2013
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Provider Practice Location Address
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Address Line | 14601 45TH AVE SUITE 206
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City | FLUSHING
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State | NY
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Zip | 11355-2200
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Country | US
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Telephone | 718-670-3135
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Fax |
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Provider Business Mailing Address
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Address Line | 167 SANDS ST APT 509
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City | BROOKLYN
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State | NY
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Zip | 11201-7414
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Country | US
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Telephone | 718-625-4928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 006599
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 006599
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License Number State | NY
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