Healthcare Provider Details

I. General information

NPI: 1669578449
Provider Name (Legal Business Name): NARAH K HONG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NARAH K KIM O.D.

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 MARLTON PIKE E SOHO OPTICAL
CHERRY HILL NJ
08003-2301
US

IV. Provider business mailing address

1900 DEPTFORD CENTER RD
DEPTFORD NJ
08096-5624
US

V. Phone/Fax

Practice location:
  • Phone: 856-874-0011
  • Fax: 856-874-0015
Mailing address:
  • Phone: 856-874-0011
  • Fax: 856-874-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00590600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: