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General NPI Number Information
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NPI Number | 1740281955
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Entity Type | Individual
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Provider Name | MIN JUNG KU M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2300 COMPUTER RD STE E25
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1737
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Country | US
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Telephone | 215-659-5480
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Fax | 215-659-5482
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Provider Business Mailing Address
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Address Line | 660 WHITE PLAINS RD STE 400
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City | TARRYTOWN
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State | NY
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Zip | 10591-5107
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Country | US
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Telephone | 914-984-2546
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Fax |
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 25MA07702500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MD424863
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License Number State | PA
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