Mun Hyuk Kwon, PIC

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI02424800 Issued in NJ

Practice address

17 Broad Ave
Palisades Park, NJ 07650-1403

Phone

(201) 313-0111

Fax

(201) 313-0577

NPI assigned

Sep 18, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Broad Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Palisades Park, NJ
  • NPI 1548358823
  NPD (past) Authorized official
• Broad Pharmacy 1 LLC

  • Community/Retail Pharmacy
  • Palisades Park, NJ
  • NPI 1437935632
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912426354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501403",
            "telephone_number": "201-313-0111",
            "fax_number": "201-313-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501403",
            "telephone_number": "201-313-0111",
            "fax_number": "201-313-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "MUN HYUK",
        "name_prefix": "Mr.",
        "credential": "PIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02424800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yeonju Kim
• Yoonjoo Kim, M.D.
• Jill Marie Koerner, RPH
• Ashley Kwak
• Soochung Karen Kwak, D.M.D.
• Tiffany Lamb
• Banghun Lee, DDS
• Chang Hee Lee
• Eun Kyung Lee, LAC.
• Eun-Jung Lee, DDS

• Pharmacist in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.