Provider Demographics
NPI:1831267087
Name:SUN, DEREK (MD)
Entity type:Individual
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First Name:DEREK
Middle Name:
Last Name:SUN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:454 FORT WASHINGTON AVE
Mailing Address - Street 2:UNIT #5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4650
Mailing Address - Country:US
Mailing Address - Phone:212-928-8800
Mailing Address - Fax:718-631-8815
Practice Address - Street 1:194-02 NORTHERN BLVD.
Practice Address - Street 2:SUITE 208
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358
Practice Address - Country:US
Practice Address - Phone:718-631-8800
Practice Address - Fax:718-631-8815
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-03-09
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Provider Licenses
StateLicense IDTaxonomies
NY250883207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease