Provider Demographics
NPI:1336554815
Name:EZRA MEDICAL CARE PC
Entity type:Organization
Organization Name:EZRA MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANG JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-886-9115
Mailing Address - Street 1:15009 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3888
Mailing Address - Country:US
Mailing Address - Phone:718-886-7575
Mailing Address - Fax:718-886-7574
Practice Address - Street 1:15009 NORTHERN BLVD
Practice Address - Street 2:1FL
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3888
Practice Address - Country:US
Practice Address - Phone:718-886-9115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty