Provider Demographics
NPI:1326644956
Name:HONG PAK MD PC
Entity Type:Organization
Organization Name:HONG PAK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HONG
Authorized Official - Middle Name:SIK
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-805-5601
Mailing Address - Street 1:15001 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3896
Mailing Address - Country:US
Mailing Address - Phone:718-746-4919
Mailing Address - Fax:888-502-9368
Practice Address - Street 1:15001 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3896
Practice Address - Country:US
Practice Address - Phone:718-746-4919
Practice Address - Fax:888-502-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty