Healthcare Provider Details

I. General information

NPI: 1922943174
Provider Name (Legal Business Name): RICHARD JOONGWON YOON RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BERGEN BLVD APT 315
FAIRVIEW NJ
07022-1574
US

IV. Provider business mailing address

333 BERGEN BLVD APT 315
FAIRVIEW NJ
07022-1574
US

V. Phone/Fax

Practice location:
  • Phone: 201-694-4035
  • Fax:
Mailing address:
  • Phone: 201-694-4035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR17618200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: