Provider Demographics
NPI:1922870005
Name:HONG, HAESOOK
Entity Type:Individual
Prefix:
First Name:HAESOOK
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 STEVERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1240
Mailing Address - Country:US
Mailing Address - Phone:267-968-5984
Mailing Address - Fax:
Practice Address - Street 1:103 STEVERS MILL RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1240
Practice Address - Country:US
Practice Address - Phone:267-968-5984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health