Provider Demographics
NPI:1245791086
Name:NY QUEENS NP ADULT HEALTH CARE PC
Entity type:Organization
Organization Name:NY QUEENS NP ADULT HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUNKYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:JEONG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-368-6691
Mailing Address - Street 1:351 HERRICKS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3724
Mailing Address - Country:US
Mailing Address - Phone:347-368-6691
Mailing Address - Fax:
Practice Address - Street 1:3819 UNION ST STE 204
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5588
Practice Address - Country:US
Practice Address - Phone:347-368-6691
Practice Address - Fax:929-999-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty