Provider Demographics
NPI:1659330546
Name:SUNKYUNG J HONG MD PC
Entity Type:Organization
Organization Name:SUNKYUNG J HONG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF PC
Authorized Official - Prefix:
Authorized Official - First Name:SUNKYUNG
Authorized Official - Middle Name:J
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-733-7015
Mailing Address - Street 1:10 OLD WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2419
Mailing Address - Country:US
Mailing Address - Phone:315-733-7015
Mailing Address - Fax:315-733-7015
Practice Address - Street 1:107 E CHESTNUT ST
Practice Address - Street 2:STE 100
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2834
Practice Address - Country:US
Practice Address - Phone:315-339-4455
Practice Address - Fax:315-339-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
54056BMedicare ID - Type Unspecified
D76910Medicare UPIN