Healthcare Provider Details

I. General information

NPI: 1437097904
Provider Name (Legal Business Name): HANEUL NP IN FAMILY HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4331 209TH ST
BAYSIDE NY
11361-2761
US

IV. Provider business mailing address

4331 209TH ST
BAYSIDE NY
11361-2761
US

V. Phone/Fax

Practice location:
  • Phone: 718-224-2017
  • Fax: 718-229-1901
Mailing address:
  • Phone: 718-224-2017
  • Fax: 718-229-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HWANG
Title or Position: AUTHORIZED PERSON
Credential: NP
Phone: 718-224-2017