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1912974619

NPI Code Detail

MEDICARE: DR. ELIZABETH TAK FUN HO MD

MEDICARE: DR. ELIZABETH TAK FUN HO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD044235L	PA
2	207R00000X	Internal Medicine Physician	185920	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CC8362	OTHER	NY	RR MEDICARE GROUP
3	110225125	OTHER	NY	RR MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912974619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH TAK FUN HO MD

Provider Business Mailing Address
First Line	:	1 GUTHRIE SQ
Second Line	:
City	:	SAYRE
State	:	PA
Zip	:	18840-1625
Country	:	US
Telephone Number	:	570-888-5858
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 ARNOT RD
Second Line	:	SUITE A
City	:	HORSEHEADS
State	:	NY
Zip	:	14845-8533
Country	:	US
Telephone Number	:	607-739-3874
Fax Number	:	607-739-3632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	03/05/2021

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Directions to “ DR. ELIZABETH TAK FUN HO MD” Practice Location

Language	Start Address	Practice Location

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