Provider Demographics
NPI:1154535607
Name:B BANG MD PA
Entity type:Organization
Organization Name:B BANG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BYUNG KEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-799-4644
Mailing Address - Street 1:9 SCHALKS CROSSING ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:609-799-4644
Mailing Address - Fax:609-799-4614
Practice Address - Street 1:9 SCHALKS CROSSING ROAD
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:609-799-4644
Practice Address - Fax:609-799-4614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093471Medicare PIN