| Ji Medical Group Pc | |
|
3825 Parsons Blvd Ste 1g Flushing NY 11354-5837 | |
| (718) 353-4100 | |
| (718) 939-5500 |
| Full Name | Ji Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3825 Parsons Blvd, Flushing, New York |
| Authorized Official Name and Position | Junho Lee (MD) |
| Authorized Official Contact | 7183534100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ji Medical Group Pc 3825 Parsons Blvd Ste 1g Flushing NY 11354-5837 Ph: (718) 353-4100 | Ji Medical Group Pc 3825 Parsons Blvd Ste 1g Flushing NY 11354-5837 Ph: (718) 353-4100 |
| NPI Number | 1043762404 |
|---|---|
| Provider Enumeration Date | 11/01/2016 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 0244512267 |
|---|---|
| Medicare Enrollment ID | O20170126000490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043762404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 166634 (New York) | Secondary |
| 207R00000X | Internal Medicine | 166634 (New York) | Primary |
| Provider Name | Colleen Insook Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710078993 PECOS PAC ID: 0446351191 Enrollment ID: I20120313000666 |
| Provider Name | Junho Bok Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245321462 PECOS PAC ID: 0446343727 Enrollment ID: I20120322000162 |
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