# S J PAHNG MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679776355
- **Authorized official:** DR. SUNG J PAHNG M.D. (PRESIDENT)
- **Authorized official phone:** (718) 353-6835

## Contact information

- **Practice address:** 21704 NORTHERN BLVD, SUITE 2, BAYSIDE, NY 11361-3577
- **Practice address phone:** (718) 353-6835
- **Practice address fax:** (718) 353-6854
- **Mailing address:** 21704 NORTHERN BLVD, SUITE 2, BAYSIDE, NY 11361-3577
- **Mailing address phone:** (718) 353-6835
- **Mailing address fax:** (718) 353-6854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QP3300X | Pain Clinic/Center | 188371 | NY | — |
| 261QR0400X | Rehabilitation Clinic/Center | 188371 | NY | Yes |

## Other

- **Enumeration date:** 06/08/2007
- **Last updated:** 11/25/2014