Provider Demographics
NPI:1184756744
Name:JIANG, MING (MD)
Entity type:Individual
Prefix:DR
First Name:MING
Middle Name:
Last Name:JIANG
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 1:143-26 41ST AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:261-509-1962
Mailing Address - Fax:
Practice Address - Street 1:1508 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3808
Practice Address - Country:US
Practice Address - Phone:718-376-3383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082639207ZP0102X
MO2003079560207ZP0102X
OH35082813207ZP0102X
NY226469207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1D159EM171Medicare PIN
MOH95633Medicare UPIN
NYWEM171Medicare PIN
NY1D15905171Medicare PIN