Provider Demographics
NPI:1619209533
Name:YOON, NINA KYUNGSOOK (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:KYUNGSOOK
Last Name:YOON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 TAFT RD
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1011
Mailing Address - Country:US
Mailing Address - Phone:201-489-4856
Mailing Address - Fax:
Practice Address - Street 1:102 THE AMERICAN RD
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2443
Practice Address - Country:US
Practice Address - Phone:800-552-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI022525001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist