Provider Demographics
NPI:1962279646
Name:MOK, HYEJUNG
Entity type:Individual
Prefix:
First Name:HYEJUNG
Middle Name:
Last Name:MOK
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 1:4454 BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3120
Mailing Address - Country:US
Mailing Address - Phone:401-871-8243
Mailing Address - Fax:
Practice Address - Street 1:4454 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-3120
Practice Address - Country:US
Practice Address - Phone:609-625-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04347400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist