Health Corner Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

229848 Issued in NY

Legal business name

HEALTH CORNER MEDICAL PC

Practice address

9301 Roosevelt Ave
Jackson Heights, NY 11372-7943

Phone

(718) 334-0001

Fax

(718) 334-0093

NPI assigned

Dec 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Sea Hyun Chung, M.D

Title

President

Phone

(718) 334-0001

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324944000000",
    "number": "1730458498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727943",
            "telephone_number": "718-334-0001",
            "fax_number": "718-334-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727943",
            "telephone_number": "718-334-0001",
            "fax_number": "718-334-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CORNER MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-27",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "SEA",
        "authorized_official_middle_name": "HYUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-334-0001",
        "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": "229848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02658611",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; 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.