Doctor Name: | DONG SEOK HAN |
NPI Number: | 1144430968 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M. DIV. |
License Number: | |
Business Practice Address: | 37 E Allendale Ave Allendale, NJ - 074012095 |
Business Phone Number: | 2013272424 |
Business Fax Number: | 2018480062 |
Mailing Address: | 575 Main St, Apt 10c CHATHAM |
State: | NJ |
Postal Code: | 079282124 |
Phone Number: | 9736651186 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |