Organization
SOUTH SHORE HEAD & NECK SURGERY MD., PC.
Active
Other names
Moo Young Jun, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOO YOUNG JUN M.D. (OWNER)
(516) 764-3732
Entity
Organization
Contact information
Practice address
135 ROCKAWAY TURNPIKE, SUITE 106, LAWRENCE, NY 11559-1023
(516) 239-3225
(516) 764-3127
Mailing address
132 SEAMAN AVENUE, ROCKVILLE CENTRE, NY 11570-3233
(516) 764-3732
(516) 764-3127
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
117557
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00218171
—
NY
Enumeration date
09/26/2012
Last updated
09/26/2012
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