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General NPI Number Information
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NPI Number | 1154698942
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Entity Type | Individual
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Provider Name | JA SUNG
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Gender | Female
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 377 VALLEY RD
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City | CLIFTON
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State | NJ
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Zip | 07013-1319
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Country | US
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Telephone | 973-278-8876
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Fax |
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Provider Business Mailing Address
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Address Line | 8300 WARRENS WAY
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City | WANAQUE
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State | NJ
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Zip | 07465-1611
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Country | US
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Telephone | 201-289-6510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | NJ28RI01518900
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License Number State | NJ
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