Provider Demographics
NPI:1720674716
Name:JONG, JIULIN
Entity Type:Individual
Prefix:
First Name:JIULIN
Middle Name:
Last Name:JONG
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 1:77 US HIGHWAY 206
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-3262
Mailing Address - Country:US
Mailing Address - Phone:973-426-0466
Mailing Address - Fax:973-448-9924
Practice Address - Street 1:77 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-3262
Practice Address - Country:US
Practice Address - Phone:973-426-0466
Practice Address - Fax:973-448-9924
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy