Provider Demographics
NPI:1558566257
Name:GEORGE TUNG, MD PC
Entity Type:Organization
Organization Name:GEORGE TUNG, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCCORSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-783-0300
Mailing Address - Street 1:2450 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5704
Mailing Address - Country:US
Mailing Address - Phone:516-783-0300
Mailing Address - Fax:516-738-4048
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11020
Practice Address - Country:US
Practice Address - Phone:516-504-2020
Practice Address - Fax:516-504-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162044207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2144535OtherAENTA PPO
2598669OtherGHI
18F5110OtherEMPIRE BLUE CROSS-SHIELD
NY737803OtherAETNA HMO
AS851OtherOXFORD
9249627OtherCIGNA
NYCM1515OtherRAILROAD MEDICARE
1C6509OtherHEALTHNET
NY=========OtherTIN
AS851OtherOXFORD
NY2144535OtherAENTA PPO
NY737803OtherAETNA HMO