Provider Demographics
NPI:1265607303
Name:HAN, JUNG A (MD)
Entity type:Individual
Prefix:DR
First Name:JUNG A
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WEST 32ND ST.
Mailing Address - Street 2:SUITE #907
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-0990
Mailing Address - Country:US
Mailing Address - Phone:212-714-1860
Mailing Address - Fax:212-714-1861
Practice Address - Street 1:16 WEST 32ND ST.
Practice Address - Street 2:SUITE #907
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-0990
Practice Address - Country:US
Practice Address - Phone:212-714-1860
Practice Address - Fax:212-714-1861
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2110816OtherCIGNA
NY03118018Medicaid