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1306717640 NPI number — KIHOON JANG

NPI Number: 1306717640
Health Care Provider/Practitioner: KIHOON JANG

Information about “1306717640” NPI (KIHOON JANG) exists in 1306717640 in HTML format HTML  |  1306717640 in plain Text format TXT  |  1306717640 in PDF (Portable Document Format) PDF  |  1306717640 in an XML format XML  formats.

NPI Number : 1306717640 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306717640",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JANG",
    "FirstName": "KIHOON",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JANG",
    "OtherFirstName": "KEE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "285 COLUMBUS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOSTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02116-5292",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "617-236-8538",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "285 COLUMBUS AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOSTON",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02116-5292",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "617-236-8538",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/17/2025",
    "LastUpdateDate": "12/05/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "PH1002650",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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