Organization
KMJAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KUNG-MING JAN M.D. (DIRECTOR)
(718) 543-1877
Entity
Organization
Contact information
Practice address
3765 RIVERDALE AVE, SUITE 5, RIVERDALE, NY 10463-1845
(718) 601-4800
(718) 601-6102
Mailing address
3656 JOHNSON AVE, SUITE 2B, RIVERDALE, NY 10463-1609
(718) 543-1877
(718) 543-6677
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
122967
NY
207RC0000X
Cardiovascular Disease Physician
Primary
122967
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00592374
—
NY
Enumeration date
12/24/2005
Last updated
09/11/2025
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