Organization
J.S.K. MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB-SUNG S KEUM D.O. (PRESIDENT)
(917) 892-9432
Entity
Organization
Contact information
Practice address
947 COLUMBUS AVE, 3B, NEW YORK, NY 10025-3108
(917) 892-9432
(877) 721-3255
Mailing address
10248 43RD AVE, CORONA, NY 11368-2434
(718) 779-1900
(718) 803-1629
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
227598
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
227598
NY
208D00000X
General Practice Physician
Primary
227598
NY
Other
Enumeration date
11/03/2010
Last updated
11/04/2010
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