Provider Demographics
NPI:1760740088
Name:JANG, JOON HO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOON HO
Middle Name:
Last Name:JANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WORTH ST RM 402
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3050
Mailing Address - Country:US
Mailing Address - Phone:646-962-3400
Mailing Address - Fax:
Practice Address - Street 1:40 WORTH ST RM 402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3050
Practice Address - Country:US
Practice Address - Phone:646-962-3400
Practice Address - Fax:646-962-0130
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11778100207R00000X
NY299742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine