Provider Demographics
NPI:1982022786
Name:ROH, HOKYUNG (MS RD LD)
Entity Type:Individual
Prefix:
First Name:HOKYUNG
Middle Name:
Last Name:ROH
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 REDLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5706
Mailing Address - Country:US
Mailing Address - Phone:703-786-4481
Mailing Address - Fax:
Practice Address - Street 1:511 REDLAND BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5706
Practice Address - Country:US
Practice Address - Phone:703-786-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCD1715133V00000X
MDDX3016133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered