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Organization
SUFFOLK FIRST MEDICAL, P.C.
Active
Organization
SUFFOLK FIRST MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IN HO HAN M.D. (OWNER)
(631) 436-7770
Entity
Organization
Contact information
Practice address
1235 SUFFOLK AVE, BRENTWOOD, NY 11717-4511
(631) 436-7770
(631) 436-9003
Mailing address
1235 SUFFOLK AVE, BRENTWOOD, NY 11717-4511
(631) 436-7770
(631) 436-9003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01051692
—
NY
01
—
W14822
MEDICARE PTIN
NY
Enumeration date
08/31/2006
Last updated
05/04/2012
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