Provider Demographics
NPI:1336421197
Name:HONG, JUNGAH V (RPH)
Entity type:Individual
Prefix:MRS
First Name:JUNGAH
Middle Name:V
Last Name:HONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 DARTMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2810
Mailing Address - Country:US
Mailing Address - Phone:856-316-8258
Mailing Address - Fax:
Practice Address - Street 1:590 BERLIN CROSS KEYS RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-9566
Practice Address - Country:US
Practice Address - Phone:856-629-6507
Practice Address - Fax:856-629-7145
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02456900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist