Provider Demographics
NPI:1538301510
Name:LIM, HYUN JEONG (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:HYUN JEONG
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5131
Mailing Address - Country:US
Mailing Address - Phone:973-773-7070
Mailing Address - Fax:973-773-3171
Practice Address - Street 1:56 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5131
Practice Address - Country:US
Practice Address - Phone:973-773-7070
Practice Address - Fax:973-773-3171
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010636225X00000X
NJ46TR00627500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist