Provider Demographics
NPI:1497299051
Name:PARK, JIHYUN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JIHYUN
Middle Name:
Last Name:PARK
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 1:1999 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1708
Mailing Address - Country:US
Mailing Address - Phone:302-832-9772
Mailing Address - Fax:320-832-3766
Practice Address - Street 1:1999 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1708
Practice Address - Country:US
Practice Address - Phone:302-832-9772
Practice Address - Fax:320-832-3766
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist