Provider Demographics
NPI:1063509362
Name:HWANG, CHENG-HONG (DO, PH D)
Entity Type:Individual
Prefix:DR
First Name:CHENG-HONG
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:DO, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1252
Mailing Address - Country:US
Mailing Address - Phone:908-272-2270
Mailing Address - Fax:908-272-0558
Practice Address - Street 1:1457 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1252
Practice Address - Country:US
Practice Address - Phone:908-272-2270
Practice Address - Fax:908-272-0558
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03912200207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3178307Medicaid
NJC54208Medicare UPIN
NJ3178307Medicaid