Seoyoon Chang
Individual provider Active NPI Pharmacist · Bergenfield, NJ
NPI 1487973400 · NPPES record last updated Jun 1, 2010
Key facts
- NPI
- 1487973400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI03111200 (NJ)
- Practice address
- 425 S Washington Ave
Bergenfield, NJ 07621-4313 - Phone
- (201) 384-1147
- Fax
- (201) 384-0625
- NPI assigned
- Jun 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03111200 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03111200 | NJ | Yes |
Addresses
Primary practice location
425 S Washington Ave
Bergenfield, NJ 07621-4313
Mailing address
425 S Washington Ave
Bergenfield, NJ 07621-4313
Other providers in Bergenfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.