NPIMap

Organization Active NPI

Lifetree Internal Medicine

  • Internal Medicine Physician
  • Aldie, VA
National Provider Identifier
1326555087
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFETREE INTERNAL MEDICINE
Practice address
24585 Stone Carver Dr Ste 100
Aldie, VA 20105-2798
Phone
(716) 868-9146
NPI assigned
Jan 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Authorized official

Name
Dr. Dongjin Sung, M.D.NPI 1114231198
Title
Owner
Phone
(716) 868-9146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

24585 Stone Carver Dr Ste 100
Aldie, VA 20105-2798

Mailing address

6405 Woodsong CT
MC Lean, VA 22101-4122

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1326555087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 WOODSONG CT",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24585 STONE CARVER DR STE 100",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201052798",
            "telephone_number": "716-868-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETREE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "SUNG",
        "authorized_official_first_name": "DONGJIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-868-9146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aldie, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.