Healthcare Provider Details

I. General information

NPI: 1235967365
Provider Name (Legal Business Name): YOUN YOUNG HUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE HUR

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BERGEN ST STE 1106
NEWARK NJ
07107-3001
US

IV. Provider business mailing address

5746 225TH ST
BAYSIDE NY
11364-2043
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-2513
  • Fax:
Mailing address:
  • Phone: 516-509-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number781605
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: