Im, Won Gi
Im, Won Gi is an sole proprietor health care provider with primary practice located at 221 Broadway Suite 303, Amityville NY 11701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Im, Won Gi can be contacted via phone (631) 789-7429.Contact Information
Primary practice address
221 Broadway Suite 303
Amityville NY 11701
Phone: (631) 789-7429
Fax: (631) 789-8571
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 107772 | New York |
Profile Details
| NPI number | 1508932989 |
|---|---|
| LBN Legal business name | Im, Won Gi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Mar 15th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508932989 | NPPES |
| New York | MEDICAID | 00190092 |
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