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General NPI Number Information
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NPI Number | 1053555961
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Entity Type | Individual
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Provider Name | SANG H JHO MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 1111 MONTAUK HWY STE 2-2
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City | WEST ISLIP
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State | NY
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Zip | 11795-4910
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Country | US
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Telephone | 917-568-8540
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Fax | 949-577-4300
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Provider Business Mailing Address
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Address Line | PO BOX 512
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City | SMITHTOWN
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State | NY
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Zip | 11787
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Country | US
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Telephone | 917-568-8540
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Fax | 949-577-4300
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 252034
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License Number State | NY
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