Provider Demographics
NPI:1801050778
Name:HAN, YOON O (DPM)
Entity type:Individual
Prefix:
First Name:YOON
Middle Name:O
Last Name:HAN
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ENGLE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2446
Mailing Address - Country:US
Mailing Address - Phone:201-227-0700
Mailing Address - Fax:201-227-0703
Practice Address - Street 1:185 ENGLE ST STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2446
Practice Address - Country:US
Practice Address - Phone:201-227-0700
Practice Address - Fax:201-227-0703
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00310900213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MD00310900OtherLICENSE