Provider Demographics
NPI:1386620805
Name:SUNG, LINDA (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:SUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:516-739-2100
Mailing Address - Fax:516-739-2178
Practice Address - Street 1:200 OLD COUNTRY RD
Practice Address - Street 2:SUITE 350
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-739-2100
Practice Address - Fax:516-739-2178
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193148207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology