Individual
DR. ILL SUNG NA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
477 WILLIS AVE, NARCO FREEDOM, BRONX, NY 10455-4015
(718) 292-4640
(718) 292-4640
Mailing address
477 WILLIS AVE, BRONX, NY 10455-4015
(718) 292-4640
(718) 292-4640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
154224
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787875
—
NY
Enumeration date
09/14/2006
Last updated
09/23/2013
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