Provider Demographics
NPI:1992966469
Name:KUO, JONATHANN C (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHANN
Middle Name:C
Last Name:KUO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:281 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1831
Mailing Address - Country:US
Mailing Address - Phone:646-596-7386
Mailing Address - Fax:646-360-2739
Practice Address - Street 1:281 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1831
Practice Address - Country:US
Practice Address - Phone:646-596-7386
Practice Address - Fax:646-360-2739
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2013-04-16
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Provider Licenses
StateLicense IDTaxonomies
NY241732-1207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400014101Medicare PIN