Individual
JIYONG AHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
716 BROADWAY APT 1, BAYONNE, NJ 07002-4763
(646) 522-2104
Mailing address
716 BROADWAY APT 1, BAYONNE, NJ 07002-4763
(646) 522-2104
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
187193
NY
2085R0204X
Vascular & Interventional Radiology Physician
0101257691
VA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
44196
CT
2085R0204X
Vascular & Interventional Radiology Physician
D79532
MD
2085R0204X
Vascular & Interventional Radiology Physician
MD45416
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194873
GROUP MEDICARE PTAN
PA
01
—
2323842
MEDICARE GROUP PTAN
NC
01
—
339L
MEDICARE GROUP PTAN
MD
01
—
789510
GROUP MEDICARE PTAN
IL
01
—
789511
GROUP MEDICARE PTAN
IL
01
—
C10441
MEDICARE GROUP PTAN
VA
01
—
D100037356
GROUP MEDICARE PTAN
CT
01
—
G01618
GROUP MEDICARE PTAN
VA
Enumeration date
07/13/2005
Last updated
06/06/2025
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