Provider Demographics
NPI:1467223727
Name:AO HEALTH PHYSICIAN PC
Entity Type:Organization
Organization Name:AO HEALTH PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUNHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:AO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:929-969-6808
Mailing Address - Street 1:1912 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3911
Mailing Address - Country:US
Mailing Address - Phone:929-969-6808
Mailing Address - Fax:718-709-4298
Practice Address - Street 1:1912 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3911
Practice Address - Country:US
Practice Address - Phone:929-969-6808
Practice Address - Fax:718-709-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty