MEDICARE: MONICA HYUN JU AN N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	307860	NY
2	363LP2300X	Primary Care Nurse Practitioner	537603	NY
3	363LA2200X	Adult Health Nurse Practitioner	F307860	NY

General Provider Information

NPI Number	:	1578019907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA HYUN JU AN N.P.

Provider Business Mailing Address
First Line	:	600 12TH ST APT 507
Second Line	:
City	:	PALISADES PARK
State	:	NJ
Zip	:	07650-2083
Country	:	US
Telephone Number	:	347-301-4575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1468 MADISON AVE # 1157
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6508
Country	:	US
Telephone Number	:	212-241-8087
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	03/12/2025

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