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Individual

DIANA KATE SUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
14472 NORTHERN BLVD STE 203, FLUSHING, NY 11354-4231
(718) 886-9000
Mailing address
4012 80TH ST STE 5A, ELMHURST, NY 11373-1234
(718) 886-9000
(718) 961-0666

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
191741-1
NY
207NP0225X
Pediatric Dermatology Physician
191741
NY
207NS0135X
Procedural Dermatology Physician
191741
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02492419
NY
Enumeration date
10/24/2006
Last updated
02/14/2022
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