Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 206004 | NY |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 206004 | NY |
NPI | 1003802547 |
---|---|
Provider Name | Dr. George Juang |
First Address | Flushing, NY 11355-3869 |
Second Address | Flushing, NY 11355-3869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02280977 | (05) | NY |
G78205 | (02) | NY |