Provider Demographics
NPI:1295284404
Name:YOOK, SUNG HWA
Entity type:Individual
Prefix:
First Name:SUNG HWA
Middle Name:
Last Name:YOOK
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 1:7031 LITTLE RIVER TPKE STE 9B
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5958
Mailing Address - Country:US
Mailing Address - Phone:703-237-8178
Mailing Address - Fax:703-532-4379
Practice Address - Street 1:7031 LITTLE RIVER TPKE STE 9B
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5958
Practice Address - Country:US
Practice Address - Phone:703-237-8178
Practice Address - Fax:703-532-4379
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA02022111189OtherPMP