Provider Demographics
NPI:1033468988
Name:SYOSSET MEDICAL SERVICE, PLLC
Entity Type:Organization
Organization Name:SYOSSET MEDICAL SERVICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINGPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:718-913-9826
Mailing Address - Street 1:75 COACHMAN PL W
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3048
Mailing Address - Country:US
Mailing Address - Phone:718-886-6625
Mailing Address - Fax:718-886-6624
Practice Address - Street 1:3712 PRINCE ST STE 6B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4651
Practice Address - Country:US
Practice Address - Phone:718-886-6625
Practice Address - Fax:718-886-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253919261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03495278Medicaid