Individual
BONG SUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2545 SCHOENERSVILLE RD FL 2, BETHLEHEM, PA 18017-7300
(484) 884-5666
(484) 884-2224
Mailing address
1605 N CEDAR CREST BLVD STE 411, ALLENTOWN, PA 18104-2323
(484) 330-1377
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA063456
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA063456
STATE LICENSE
PA
Enumeration date
10/29/2020
Last updated
06/07/2022
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