Provider Demographics
NPI:1235363151
Name:SUNG WU SUN M.D.P.C
Entity Type:Organization
Organization Name:SUNG WU SUN M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNG WU
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-826-1626
Mailing Address - Street 1:PO BOX 484
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-0484
Mailing Address - Country:US
Mailing Address - Phone:914-826-1626
Mailing Address - Fax:
Practice Address - Street 1:12 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2026
Practice Address - Country:US
Practice Address - Phone:914-664-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249548207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02620744Medicaid
NYI12902Medicare UPIN
NY02620744Medicaid