Provider Demographics
NPI:1851351282
Name:JOO, RICHARD HONG KI (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HONG KI
Last Name:JOO
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 1:464 HUDSON TER
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2902
Mailing Address - Country:US
Mailing Address - Phone:201-567-7725
Mailing Address - Fax:201-567-5255
Practice Address - Street 1:464 HUDSON TER
Practice Address - Street 2:SUITE 203
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2902
Practice Address - Country:US
Practice Address - Phone:201-567-7725
Practice Address - Fax:201-567-5255
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237432207R00000X
NJ25MA08026600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI45510Medicare UPIN
NY164SH1Medicare ID - Type Unspecified