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General NPI Number Information
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NPI Number | 1679776355
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Entity Type | Organization
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Legal Business Name | S J PAHNG MD PC
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 21704 NORTHERN BLVD SUITE 2
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City | BAYSIDE
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State | NY
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Zip | 11361-3577
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Country | US
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Telephone | 718-353-6835
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Fax | 718-353-6854
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Provider Business Mailing Address
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Address Line | 21704 NORTHERN BLVD SUITE 2
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City | BAYSIDE
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State | NY
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Zip | 11361-3577
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Country | US
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Telephone | 718-353-6835
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Fax | 718-353-6854
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNG J PAHNG
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Credential | M.D.
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Telephone | 718-353-6835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 188371
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 188371
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License Number State | NY
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