Provider Demographics
NPI:1295025427
Name:WON SOHN, M.D.,P.C.
Entity Type:Organization
Organization Name:WON SOHN, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WON
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-781-5821
Mailing Address - Street 1:P.O.BOX 605043
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360
Mailing Address - Country:US
Mailing Address - Phone:718-428-5333
Mailing Address - Fax:718-428-5332
Practice Address - Street 1:213-33 39TH AVE
Practice Address - Street 2:SUITE 248
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361
Practice Address - Country:US
Practice Address - Phone:718-428-5333
Practice Address - Fax:718-428-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207025261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02088860Medicaid
NYWS043C6310Medicare PIN