| Sun Medical P.c | |
|
2200 Fletcher Ave 1st Floor Fort Lee NJ 07024-5005 | |
| (201) 944-3115 | |
| Not Available |
| Full Name | Sun Medical P.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 2200 Fletcher Ave, Fort Lee, New Jersey |
| Authorized Official Name and Position | Sung Wook Sun (M.D.) |
| Authorized Official Contact | 2019443115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Medical P.c 339 Summit St Norwood NJ 07648-1218 Ph: (201) 768-1918 | Sun Medical P.c 2200 Fletcher Ave 1st Floor Fort Lee NJ 07024-5005 Ph: (201) 944-3115 |
| NPI Number | 1235233362 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8527063007 |
|---|---|
| Medicare Enrollment ID | O20060918000093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235233362 | NPI | - | NPPES |
| 0092312 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07942200 (New Jersey) | Primary |
| Provider Name | Sung Wook Sun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932125994 PECOS PAC ID: 4486687365 Enrollment ID: I20050912000905 |
| Provider Name | Jun Z Shim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801222492 PECOS PAC ID: 9739310202 Enrollment ID: I20140326000745 |
| Provider Name | Joonhye Kook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639576325 PECOS PAC ID: 7719200393 Enrollment ID: I20171127002236 |
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