Provider Demographics
NPI:1164690616
Name:JO, HANNAH (PA-C)
Entity Type:Individual
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First Name:HANNAH
Middle Name:
Last Name:JO
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:201
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6000
Mailing Address - Fax:516-622-2914
Practice Address - Street 1:2501 N GLEBE RD
Practice Address - Street 2:101
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3558
Practice Address - Country:US
Practice Address - Phone:703-469-3972
Practice Address - Fax:703-243-9001
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2016-04-06
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Provider Licenses
StateLicense IDTaxonomies
VA0110002677363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical