Provider Demographics
NPI:1568607919
Name:JANG, HANGJUN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:HANGJUN
Middle Name:
Last Name:JANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15009 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3888
Mailing Address - Country:US
Mailing Address - Phone:718-886-7575
Mailing Address - Fax:
Practice Address - Street 1:15009 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3888
Practice Address - Country:US
Practice Address - Phone:718-886-7575
Practice Address - Fax:718-886-7574
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00669OtherMEDICARE GROUP
NY02993566OtherMEDICAID GROUP
NY03079747Medicaid
NY02993566OtherMEDICAID GROUP