Basic Information
| Provider Information | |||||||||
| NPI: | 1972759165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HONG | ||||||||
| FirstName: | JIWON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 COMMUNITY DRIVE | ||||||||
| Address2: | DIVISION OF HOSPITAL MEDICINE 4DSU | ||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165622945 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 300 COMMUNITY DRIVE | ||||||||
| Address2: | DIVISION OF HOSPITAL MEDICINE 4DSU | ||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165622945 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 252613 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.