Provider Demographics
NPI:1720390180
Name:KOVACS, HAKKYUNG LEE (NPC)
Entity type:Individual
Prefix:
First Name:HAKKYUNG
Middle Name:LEE
Last Name:KOVACS
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6641
Mailing Address - Country:US
Mailing Address - Phone:201-952-9529
Mailing Address - Fax:201-497-8901
Practice Address - Street 1:1031 MCBRIDE AVE
Practice Address - Street 2:SUITE C204
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2559
Practice Address - Country:US
Practice Address - Phone:973-785-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ99280163WC0200X
NJNN99280363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine