Provider Demographics
NPI:1730614249
Name:BAE, JANG HWAN (DO)
Entity type:Individual
Prefix:DR
First Name:JANG HWAN
Middle Name:
Last Name:BAE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4767
Mailing Address - Country:US
Mailing Address - Phone:848-306-5957
Mailing Address - Fax:
Practice Address - Street 1:731 ROUTE 35
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4767
Practice Address - Country:US
Practice Address - Phone:732-455-8444
Practice Address - Fax:609-677-7201
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-22
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MB10894300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program