Provider Demographics
NPI:1033492137
Name:KIM, HYO JUNG J (PHARM-D)
Entity Type:Individual
Prefix:MS
First Name:HYO JUNG
Middle Name:J
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CAROL LN
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2127
Mailing Address - Country:US
Mailing Address - Phone:201-796-1142
Mailing Address - Fax:201-796-5909
Practice Address - Street 1:17-77 RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1205
Practice Address - Country:US
Practice Address - Phone:201-796-1142
Practice Address - Fax:201-796-5909
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02956700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist