Teodoro Y. Pang M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

126797 Issued in NY

Legal business name

TEODORO Y. PANG M.D., P.C.

Practice address

9424 59TH Ave
Elmhurst, NY 11373-5151

Phone

(718) 271-6554

Fax

(718) 760-8233

NPI assigned

Feb 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Teodoro Y. Pang, M.D.

Title

President

Phone

(718) 271-6554

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083754063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9424 59TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735151",
            "telephone_number": "718-271-6554",
            "fax_number": "718-760-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9424 59TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735151",
            "telephone_number": "718-271-6554",
            "fax_number": "718-760-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEODORO Y. PANG M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANG",
        "authorized_official_first_name": "TEODORO",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-271-6554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00640024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.