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Individual

INJUNG KO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
21102 73RD AVE, BAYSIDE, NY 11364-2855
(347) 421-4789
Mailing address
211-2 73RD AVE, BAYSIDE, NY 11364
(347) 421-4789

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310572
NY

Other

Enumeration date
11/15/2021
Last updated
04/05/2023
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