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General NPI Number Information
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NPI Number | 1649496175
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Entity Type | Organization
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Legal Business Name | HU NAM NAM MD
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13625 MAPLE AVE SUITE 201
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City | FLUSHING
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State | NY
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Zip | 11355-3870
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Country | US
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Telephone | 718-886-3300
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Fax | 718-886-8117
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Provider Business Mailing Address
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Address Line | 13625 MAPLE AVE SUITE 201
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City | FLUSHING
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State | NY
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Zip | 11355-3870
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Country | US
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Telephone | 718-886-3300
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Fax | 718-886-8117
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Authorized Official
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Title or Position | OWNER
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Name | HU NAM NAM
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Credential | MD
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Telephone | 718-886-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 163382
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License Number State | NY
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