Provider Demographics
NPI:1851729636
Name:SEO JIN MEDICAL CARE PC
Entity type:Organization
Organization Name:SEO JIN MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-255-6391
Mailing Address - Street 1:25 COLUMBUS CIR
Mailing Address - Street 2:52F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1107
Mailing Address - Country:US
Mailing Address - Phone:718-255-6391
Mailing Address - Fax:718-255-6392
Practice Address - Street 1:345 E 37TH ST
Practice Address - Street 2:310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3256
Practice Address - Country:US
Practice Address - Phone:718-255-6391
Practice Address - Fax:718-255-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty