Provider Demographics
NPI:1578773958
Name:KIM, WON JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:WON
Middle Name:JAMES
Last Name:KIM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BUSH RD
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2906
Mailing Address - Country:US
Mailing Address - Phone:973-588-3492
Mailing Address - Fax:
Practice Address - Street 1:69 NEW RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4206
Practice Address - Country:US
Practice Address - Phone:973-227-3937
Practice Address - Fax:973-227-3917
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02622100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist