Provider Demographics
NPI:1568772374
Name:JANNET UNG, MD, PLLC
Entity Type:Organization
Organization Name:JANNET UNG, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANNET
Authorized Official - Middle Name:
Authorized Official - Last Name:UNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-244-5191
Mailing Address - Street 1:333 E 34TH ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5242
Mailing Address - Country:US
Mailing Address - Phone:781-244-5191
Mailing Address - Fax:
Practice Address - Street 1:333 E 34TH ST APT 6E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5242
Practice Address - Country:US
Practice Address - Phone:781-244-5191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256771261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03250433Medicaid
NYG300023269OtherMEDICARE