Provider Demographics
NPI:1144430968
Name:HAN, DONG SEOK (M DIV)
Entity type:Individual
Prefix:
First Name:DONG SEOK
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:M DIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MAIN ST
Mailing Address - Street 2:APT 10C
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2124
Mailing Address - Country:US
Mailing Address - Phone:973-665-1186
Mailing Address - Fax:
Practice Address - Street 1:37 E ALLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-2095
Practice Address - Country:US
Practice Address - Phone:201-327-2424
Practice Address - Fax:201-848-0062
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral