Provider Demographics
NPI:1043508443
Name:HO, JIUN (DO)
Entity Type:Individual
Prefix:DR
First Name:JIUN
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:JIUN
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-666-1279
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:291 QUEEN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6379
Practice Address - Country:US
Practice Address - Phone:860-583-1845
Practice Address - Fax:860-584-1358
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME22432082S0105X
NY266044-12082S0105X
CT535572086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand