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Individual

DR. KUNG-MING JAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3050 CORLEAR AVE, SUITE 204, BRONX, NY 10463-5180
(718) 601-4800
(718) 601-6102
Mailing address
3050 CORLEAR AVE., SUITE 204, BRONX, NY 10463-5180
(718) 601-4800
(718) 601-6102

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
12/27/2005
Last updated
09/19/2012
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