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General NPI Number Information
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NPI Number | 1700045598
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Entity Type | Individual
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Provider Name | JAE GEUN HYUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 400 SYLVAN AVE STE 103
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2717
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Country | US
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Telephone | 201-227-1455
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Fax | 201-227-1499
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Provider Business Mailing Address
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Address Line | 1 GUSTAVE L LEVY PL PO BOX 1069
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City | NEW YORK
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State | NY
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Zip | 10029-6500
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 241219
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License Number State | NY
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