Provider Demographics
NPI:1447419189
Name:HONG, JIA (MD)
Entity Type:Individual
Prefix:
First Name:JIA
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4235 MAIN STREET SUITE 3K
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-886-0131
Mailing Address - Fax:718-886-0631
Practice Address - Street 1:4235 MAIN STREET SUITE 3K
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-886-0131
Practice Address - Fax:718-886-0631
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine