Most Relevant Information
Provider Data
| NPI Number: | 1003440165 |
| Provider Name: | JOHNNY JIANG |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 025117 |
Most Important Dates
| Enumeration Date: | 02/27/2020 |
| Last Updated: | 09/19/2023 |
Provider Practice Location
1455 79TH ST
BROOKLYN
NY
112282505
Practice Location Phone/Fax
| Phone: | 6462664150 |
| Fax: |
Provider Mailing Location
1455 79TH ST
BROOKLYN
NY
112282505
Provider Mailing Phone/Fax
| Phone: | 6462664150 |
| Fax: |