Individual
JONATHAN SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
560 1ST AVE FL 2, NEW YORK, NY 10016-6402
(617) 874-6858
Mailing address
4535 11TH ST # GD, LONG ISLAND CITY, NY 11101-5205
(617) 874-6858
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0000
NY
Other
Enumeration date
11/01/2023
Last updated
12/08/2023
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