MEDICARE: DR. JOHNNY KIN MAN HUNG RPH

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	183500000X	Pharmacist	28RI03163200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962720086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNNY KIN MAN HUNG RPH

Provider Business Mailing Address
First Line	:	189 SCHERMERHORN ST APT 12G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6198
Country	:	US
Telephone Number	:	347-286-9593
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 ANDERSON ST
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-3503
Country	:	US
Telephone Number	:	201-488-0654
Fax Number	:	201-883-1619

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

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	07/29/2014

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