Healthcare Provider Details

I. General information

NPI: 1679486328
Provider Name (Legal Business Name): JEANNIE HWANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 OAKRIDGE CMNS
SOUTH SALEM NY
10590-2437
US

IV. Provider business mailing address

41 LINCOLN TER
HARRINGTON PARK NJ
07640-1222
US

V. Phone/Fax

Practice location:
  • Phone: 914-533-5679
  • Fax: 914-533-5222
Mailing address:
  • Phone: 914-420-3597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI044847-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: