Provider Demographics
NPI:1952811671
Name:HWANG, YOUJIN
Entity Type:Individual
Prefix:
First Name:YOUJIN
Middle Name:
Last Name:HWANG
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 1:76 WEST OAKDENE AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1886
Mailing Address - Country:US
Mailing Address - Phone:718-309-0304
Mailing Address - Fax:
Practice Address - Street 1:1622 PARKER AVE # 1A
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6927
Practice Address - Country:US
Practice Address - Phone:201-461-4646
Practice Address - Fax:201-461-4655
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03779000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ103396483OtherCIGNA HEALTH INSURANCE