Shidong Su, Md,Pc

LBN: Shidong Su, Md,Pc
Shidong Su, Md,Pc is an health care organization with primary practice located at 13621 Roosevelt Ave Suite 305, Flushing NY 11354-5507. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as the primary health care specialty. Shidong Su, Md,Pc can be contacted via phone (718) 888-1803, or through Su, Shidong via phone (718) 888-1803.

Contact Information

Primary practice address
13621 Roosevelt Ave Suite 305 Flushing NY 11354-5507
Phone: (718) 888-1803
Fax: (718) 888-0957
Website:
Map and Directions
Authorized official contact:
Name: Su, Shidong Doctor of Medicine (MD)
Phone: (718) 888-1803

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 215043 New York

Profile Details

NPI number 1467542530
LBN Legal business name Shidong Su, Md,Pc
DBA Doing business as
Authorized official Su, Shidong Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467542530 NPPES
New York Other 05353 GHI-MEDICARE
New York MEDICAID 02159286 GHI-MEDICARE

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