Healthcare Provider Details

I. General information

NPI: 1740281955
Provider Name (Legal Business Name): MIN JUNG KU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HORSHAM RD STE 106
HORSHAM PA
19044-2146
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US

V. Phone/Fax

Practice location:
  • Phone: 215-659-5480
  • Fax: 215-659-5482
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD424863
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA07702500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: