Individual
DR. JISU HAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
154 WADSWORTH AVE., NEW YORK, NY 10033
(212) 866-3096
Mailing address
154 WADSWORTH AVE, NEW YORK, NY 10033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
316419
NY
207QS1201X
Sleep Medicine (Family Medicine) Physician
316419
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2018
Last updated
08/25/2022
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