Provider Demographics
NPI:1750522348
Name:SANG KEE PAHK MD PC
Entity type:Organization
Organization Name:SANG KEE PAHK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:K
Authorized Official - Last Name:PAHK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-939-8705
Mailing Address - Street 1:13630 MAPLE AVE
Mailing Address - Street 2:1D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3865
Mailing Address - Country:US
Mailing Address - Phone:718-939-8705
Mailing Address - Fax:718-939-8712
Practice Address - Street 1:13630 MAPLE AVE
Practice Address - Street 2:1D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3865
Practice Address - Country:US
Practice Address - Phone:718-939-8705
Practice Address - Fax:718-939-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138015207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21436Medicare PIN