Provider Demographics
NPI:1861471310
Name:WHANG, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:WHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1421
Mailing Address - Country:US
Mailing Address - Phone:973-334-2880
Mailing Address - Fax:973-588-3339
Practice Address - Street 1:24 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1421
Practice Address - Country:US
Practice Address - Phone:973-334-2880
Practice Address - Fax:973-588-3339
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA070630207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037090Medicare PIN
NYG36007Medicare UPIN