Provider Demographics
NPI:1114009388
Name:LOH, SHI-HONG (MD)
Entity Type:Individual
Prefix:
First Name:SHI-HONG
Middle Name:
Last Name:LOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 GRAND STREET SUITE 101
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3603
Mailing Address - Country:US
Mailing Address - Phone:201-659-9027
Mailing Address - Fax:201-659-7943
Practice Address - Street 1:109 GRAND ST STE 101
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-8541
Practice Address - Country:US
Practice Address - Phone:201-659-9027
Practice Address - Fax:201-659-7943
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45625207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0586803Medicaid
444374Medicare ID - Type Unspecified
NJ0586803Medicaid