Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 000055 | NY |
NPI | 1093858144 |
---|---|
Provider Name | Dr. Jong-Hyun Ban |
First Address | Brooklyn, NY 11220-3702 |
Second Address | Brooklyn, NY 11220-2559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |