Individual provider Active NPI

Eunsook Bang, M.D.

  • Legal Medicine
  • Flushing, NY
National Provider Identifier
1336298835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
152456 Issued in NY
Practice address
14703 41St Ave
1St Floor
Flushing, NY 11355-1248
Phone
(718) 762-7793
Fax
(718) 461-0324
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 152456 NY Primary

Addresses

Primary practice location

14703 41St Ave
1St Floor
Flushing, NY 11355-1248

Mailing address

147-03 41St Ave
Flushing, NY 11355
Phone (718) 762-7793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000262 NY Practitioner - Pediatric Medicine 2466504527 Practice locations: Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14703 41St Ave
Flushing, NY 11355-1248
Phone (718) 762-7793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336298835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147-03 41ST AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-762-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14703 41ST AVE",
            "address_2": "1ST FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551248",
            "telephone_number": "718-762-7793",
            "fax_number": "718-461-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANG",
        "first_name": "EUNSOOK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "152456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.