Provider Demographics
NPI:1932374931
Name:DR. KAM POON, M.D., P.C.
Entity Type:Organization
Organization Name:DR. KAM POON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAM
Authorized Official - Middle Name:CHOI
Authorized Official - Last Name:POON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-946-6730
Mailing Address - Street 1:8504 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3208
Mailing Address - Country:US
Mailing Address - Phone:718-946-6730
Mailing Address - Fax:718-946-7016
Practice Address - Street 1:8504 21ST AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3208
Practice Address - Country:US
Practice Address - Phone:718-946-6730
Practice Address - Fax:718-946-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty