Provider Demographics
NPI:1548798473
Name:HAN, MINA PI (OD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:PI
Last Name:HAN
Suffix:
Gender:F
Credentials:OD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N RTE 17
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2906
Mailing Address - Country:US
Mailing Address - Phone:201-262-7100
Mailing Address - Fax:
Practice Address - Street 1:125 ROUTE 46
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2338
Practice Address - Country:US
Practice Address - Phone:973-890-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00673200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist