| Hanmi Medical Associates Pa | |
|
784 Grand Ave Ste 201 Ridgefield NJ 07657-1043 | |
| (201) 724-6410 | |
| (201) 346-0118 |
| Full Name | Hanmi Medical Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 784 Grand Ave Ste 201, Ridgefield, New Jersey |
| Authorized Official Name and Position | Wonil Park (PRESIDENT) |
| Authorized Official Contact | 2013460999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hanmi Medical Associates Pa 784 Grand Ave Ste 201 Ridgefield NJ 07657-1043 Ph: (201) 724-6410 | Hanmi Medical Associates Pa 784 Grand Ave Ste 201 Ridgefield NJ 07657-1043 Ph: (201) 724-6410 |
| NPI Number | 1164683017 |
|---|---|
| Provider Enumeration Date | 06/23/2008 |
| Last Update Date | 05/07/2020 |
| Medicare PECOS PAC ID | 5799960688 |
|---|---|
| Medicare Enrollment ID | O20110419000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164683017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA05730500 (New Jersey) | Secondary |
| 207R00000X | Internal Medicine | 25MA05851500 (New Jersey) | Primary |
| Provider Name | Wonil Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588753842 PECOS PAC ID: 5395787618 Enrollment ID: I20050526000662 |
| Provider Name | Yoonjoo Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598841942 PECOS PAC ID: 1456393776 Enrollment ID: I20050526000697 |
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