Provider Demographics
NPI:1073052668
Name:YOON, SOWON (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOWON
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MONUMENT RD
Mailing Address - Street 2:SUITE 601D
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1702
Mailing Address - Country:US
Mailing Address - Phone:888-590-0808
Mailing Address - Fax:866-740-4689
Practice Address - Street 1:150 MONUMENT RD
Practice Address - Street 2:SUITE 601D
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1702
Practice Address - Country:US
Practice Address - Phone:888-590-0808
Practice Address - Fax:866-740-4689
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447352183500000X
NJ28RI03531800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist