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General NPI Number Information
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NPI Number | 1710001359
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Entity Type | Organization
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Legal Business Name | JI HAN, MD, PLLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3420 PARSONS BLVD SUITE LR-LS
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City | FLUSHING
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State | NY
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Zip | 11354-4637
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Country | US
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Telephone | 347-420-9845
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Fax |
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Provider Business Mailing Address
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Address Line | 435 E 70TH ST APT 17J
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City | NEW YORK
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State | NY
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Zip | 10021-5342
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Country | US
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Telephone | 347-420-9845
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JI HYEON HAN
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Credential | M.D.
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Telephone | 347-420-9845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 232226
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License Number State | NY
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