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Individual

ELIJAH SE HONG MIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
31 MAIN RD STE 2, RIVERHEAD, NY 11901-1953
(631) 369-8539
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
AS2383278
NY
208600000X
Surgery Physician
Primary
284575
NY

Other

Enumeration date
07/17/2010
Last updated
09/11/2018
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