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General NPI Number Information
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NPI Number | 1750522348
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Entity Type | Organization
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Legal Business Name | SANG KEE PAHK MD PC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 13630 MAPLE AVE 1D
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City | FLUSHING
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State | NY
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Zip | 11355-3865
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Country | US
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Telephone | 718-939-8705
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Fax | 718-939-8712
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Provider Business Mailing Address
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Address Line | 13630 MAPLE AVE 1D
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City | FLUSHING
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State | NY
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Zip | 11355-3865
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Country | US
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Telephone | 718-939-8705
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Fax | 718-939-8712
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANG K PAHK
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Credential | M.D.
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Telephone | 718-939-8705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 138015
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License Number State | NY
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