Provider Demographics
NPI:1619271897
Name:MYUNG GASTROENTEROLOGY, P.C.
Entity Type:Organization
Organization Name:MYUNG GASTROENTEROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOON
Authorized Official - Middle Name:MO
Authorized Official - Last Name:MYUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-445-0200
Mailing Address - Street 1:15408 NORTHERN BLVD
Mailing Address - Street 2:SUITE 2K
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5040
Mailing Address - Country:US
Mailing Address - Phone:718-445-0200
Mailing Address - Fax:
Practice Address - Street 1:15408 NORTHERN BLVD
Practice Address - Street 2:SUITE 2K
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5040
Practice Address - Country:US
Practice Address - Phone:718-445-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256592-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty