Provider Demographics
NPI:1609195551
Name:KWON, MARIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:KWON
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 1:400 RYDERS LN
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1700
Mailing Address - Country:US
Mailing Address - Phone:732-613-3962
Mailing Address - Fax:732-867-0590
Practice Address - Street 1:400 RYDERS LN
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1700
Practice Address - Country:US
Practice Address - Phone:732-613-3962
Practice Address - Fax:732-867-0590
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03223800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist