Provider Demographics
NPI:1740208602
Name:MINN, JOON H (MD)
Entity Type:Individual
Prefix:
First Name:JOON
Middle Name:H
Last Name:MINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 FRANKLIN AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3532
Mailing Address - Country:US
Mailing Address - Phone:973-751-2011
Mailing Address - Fax:973-751-4456
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2030
Practice Address - Fax:973-751-4456
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA076016002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8882207Medicaid
NJ8882207Medicaid
NJ532571Medicare ID - Type Unspecified