Provider Demographics
NPI:1558436832
Name:LO, JIUN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JIUN
Middle Name:H
Last Name:LO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JIUN
Other - Middle Name:HONG
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1553 HIGHWAY 27
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3980
Mailing Address - Country:US
Mailing Address - Phone:732-828-0102
Mailing Address - Fax:732-828-0406
Practice Address - Street 1:1553 HIGHWAY 27
Practice Address - Street 2:SUITE 3500
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3980
Practice Address - Country:US
Practice Address - Phone:732-828-0102
Practice Address - Fax:732-828-0406
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02588500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1063485OtherHORIZON NJ HEALTH
NJP2095866OtherOXFORD HEALTH PLAN
NJ2929007Medicaid
NJ40982OtherAETNA US HEALTH CARE
NJ0841099002OtherCIGNA HEALTH CARE
NJF06417OtherHEALTH NET
0083061OtherGHI
NJ5265493OtherAETNA HEALTH PLAN
NJ00046055Medicare ID - Type Unspecified
NJP2095866OtherOXFORD HEALTH PLAN