Basic Information
| Provider Information | |||||||||
| NPI: | 1225151343 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JI | ||||||||
| FirstName: | HOON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 543 SAW MILL BROOK PKWY | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024593614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172439924 | ||||||||
| FaxNumber: | 7143847447 | ||||||||
| Practice Location | |||||||||
| Address1: | 660 1ST AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122639531 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 231092 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085R0202X | 231092 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 301881 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085B0100X | 301881 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Body Imaging |
No ID Information.