Provider Demographics
NPI:1174758429
Name:PAHK, ALBERT JUN (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:JUN
Last Name:PAHK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13630 MAPLE AVE STE 1D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3866
Mailing Address - Country:US
Mailing Address - Phone:718-939-8705
Mailing Address - Fax:718-939-8712
Practice Address - Street 1:13630 MAPLE AVE STE 1D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3866
Practice Address - Country:US
Practice Address - Phone:718-939-8705
Practice Address - Fax:718-939-8712
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037983174400000X
NY238408-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist