Provider Demographics
NPI:1437210150
Name:RHEE, JAI J
Entity Type:Individual
Prefix:
First Name:JAI
Middle Name:J
Last Name:RHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 75TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6422
Mailing Address - Country:US
Mailing Address - Phone:718-426-6464
Mailing Address - Fax:718-565-5555
Practice Address - Street 1:3725 75TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6422
Practice Address - Country:US
Practice Address - Phone:718-426-6464
Practice Address - Fax:718-565-5555
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110023207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00598485Medicaid
NY00598485Medicaid
NY13674Medicare ID - Type Unspecified