Provider Demographics
NPI:1194042226
Name:HAK, STEPHEN JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JAMES
Last Name:HAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 STOKES RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8475
Mailing Address - Country:US
Mailing Address - Phone:609-654-0440
Mailing Address - Fax:609-714-2357
Practice Address - Street 1:409 STOKES RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8475
Practice Address - Country:US
Practice Address - Phone:609-654-0440
Practice Address - Fax:609-714-2357
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01373500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4402201Medicaid