Individual
DR. JAE H RO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19 BRADHURST AVE, STE 700, HAWTHORNE, NY 10532-2140
(914) 593-7800
(914) 593-7857
Mailing address
PO BOX 28064, NEW YORK, NY 10087-8064
(914) 593-7800
(914) 593-7881
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
128871
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00238037
—
NY
01
—
060023745
RAIL ROAD MEDICARE
NY
01
—
321573K221
PTAN
NY
Enumeration date
05/24/2005
Last updated
11/05/2015
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