Provider Demographics
NPI:1609274273
Name:GEORGE J. JUANG, M.D. PLLC
Entity Type:Organization
Organization Name:GEORGE J. JUANG, M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-286-6576
Mailing Address - Street 1:13630 MAPLE AVE STE 1G
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3869
Mailing Address - Country:US
Mailing Address - Phone:718-300-3368
Mailing Address - Fax:718-888-7836
Practice Address - Street 1:13630 MAPLE AVE STE 1G
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3869
Practice Address - Country:US
Practice Address - Phone:718-300-3368
Practice Address - Fax:718-888-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty