Provider Demographics
NPI:1205226339
Name:JANG, JIHYE
Entity Type:Individual
Prefix:
First Name:JIHYE
Middle Name:
Last Name:JANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-3104
Mailing Address - Country:US
Mailing Address - Phone:201-794-7975
Mailing Address - Fax:
Practice Address - Street 1:5000 HADLEY CENTER DR
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1140
Practice Address - Country:US
Practice Address - Phone:908-444-2023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW02271300390200000X
NJ28RI03957600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RW02271300OtherNJ STATE PHARMACY TECHNICIAN LICENSE NUMBER