Individual
ANN KEONG JU JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3800 RESERVOIR RD NW, GEORGETOWN UNIVERSITY HOSPITAL - DEPT. OF RADIOLOGY, WASHINGTON, DC 20007-2113
(202) 444-3006
Mailing address
PO BOX 418283, BOSTON, MA 02241-8283
(703) 558-1544
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
MT188570
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00894801
RAILROAD MEDICARE
DC
Enumeration date
01/10/2007
Last updated
03/08/2012
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