Provider Demographics
NPI:1366252181
Name:HYUN, JEONGMIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JEONGMIN
Middle Name:
Last Name:HYUN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 NEWCOMB RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-5520
Mailing Address - Country:US
Mailing Address - Phone:551-795-7221
Mailing Address - Fax:
Practice Address - Street 1:1622 PARKER AVE STE 2B
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6927
Practice Address - Country:US
Practice Address - Phone:201-592-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02314200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist