Individual
DR. IHN SOUGH LAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3010 GRAND CONCOURSE APT L2, BRONX, NY 10458-1534
(718) 365-8850
(718) 365-8057
Mailing address
3010 GRAND CONCOURSE APT L2, BRONX, NY 10458-1534
(718) 365-8850
(718) 365-8057
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
157642
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00829350
—
NY
Enumeration date
11/07/2006
Last updated
07/08/2007
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