Provider Demographics
NPI:1447572615
Name:BLANCHARD, HAESUNG (RPH)
Entity Type:Individual
Prefix:MS
First Name:HAESUNG
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1513
Mailing Address - Country:US
Mailing Address - Phone:732-525-0834
Mailing Address - Fax:732-525-1279
Practice Address - Street 1:2909 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1513
Practice Address - Country:US
Practice Address - Phone:732-525-0834
Practice Address - Fax:732-525-1279
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02505800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist