Individual
SANG I PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 MEETING HOUSE LANE, SURGICAL SPECIALTIES OFFICE, SOUTHAMPTON, NY 11968
(631) 726-8717
(631) 726-8720
Mailing address
PO BOX 5545, HICKSVILLE, NY 11802-5545
(631) 283-2430
(631) 283-7496
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
208286
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01925662
—
NY
Enumeration date
07/31/2006
Last updated
02/14/2018
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