Healthcare Provider Details

I. General information

NPI: 1255295572
Provider Name (Legal Business Name): SO YOUNG HAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ESSEX ST STE 100
HACKENSACK NJ
07601-4034
US

IV. Provider business mailing address

75 ESSEX ST STE 100
HACKENSACK NJ
07601-4034
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-2478
  • Fax: 201-518-8493
Mailing address:
  • Phone: 201-342-2478
  • Fax: 201-518-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04470200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: