Provider Demographics
NPI:1700580313
Name:KANG, WON JOON
Entity Type:Individual
Prefix:
First Name:WON JOON
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1553
Mailing Address - Country:US
Mailing Address - Phone:443-538-1698
Mailing Address - Fax:
Practice Address - Street 1:4411 HOWLEY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1509
Practice Address - Country:US
Practice Address - Phone:412-621-9987
Practice Address - Fax:412-621-3041
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist