Healthcare Provider Details

I. General information

NPI: 1083292346
Provider Name (Legal Business Name): HONG THAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 PARK AVE
WEEHAWKEN NJ
07086-6132
US

IV. Provider business mailing address

1 ELIAS LN UNIT 202
EAST BRUNSWICK NJ
08816-2482
US

V. Phone/Fax

Practice location:
  • Phone: 201-453-3114
  • Fax: 877-811-1227
Mailing address:
  • Phone: 732-783-6398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04162400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: