Provider Demographics
NPI:1922118033
Name:HAN, KYUNG B (MD)
Entity Type:Individual
Prefix:
First Name:KYUNG
Middle Name:B
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:260 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1722
Practice Address - Country:US
Practice Address - Phone:717-262-4660
Practice Address - Fax:717-263-6251
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1839492085R0001X, 2085R0204X
NJ25MA069349002085R0204X
PAMD4695112085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10487600OtherCAQH
NY1000066816OtherAFFINITY HEALTH PLANS
NY1768750OtherAETNA HMO PROVIDER #
NY183949-NYOther1199 HEALTH FUND PROVIDER #
NY321310OtherUS FAMILY HEALTH PLAN
NY2686E1OtherEMPIRE BCBS (YONKERS)
NY5551677OtherAETNA PPO PROVIDER #
NY080506000082OtherFIDELIS CARE
NY01267918Medicaid
NY1000066816OtherAFFINITY HEALTH PLANS
H10792Medicare UPIN