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Dorothy Santos Pang

Internal Medicine

Allopathic & Osteopathic Physicians

5645 Main St, New York Hospital Center Of Queens Emegency Department, Flushing, NY 11355

PECOS Enrollment

This provider is enrolled in PECOS as DOROTHY PANG.

Based on the most recent information from CMS, provider Dorothy Santos Pang is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1417961079
Provider Type
Individual
Full Name
Pang, Dorothy Santos
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
7/28/2006
Last Updated
7/8/2007

Contact Information

Practice Location

5645 Main St, New York Hospital Center Of Queens Emegency Department, Flushing, NY 11355

(718) 670-1231

(610) 617-6280

Mailing Location

PO Box 430, Emergency Practice Plan, Flushing, NY 11352

(610) 668-6491

(610) 617-6280

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 178954 New York

Provider Identifiers

ID	Description	Issuer
ID 01152565	Description Medicaid	Issuer Unlisted New York

Dorothy Santos Pang

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Sallam, Ammar Y

Huang, Hua