Individual
MICHAEL JIN BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MSN, FNP-C
Contact information
Practice address
170 PROSPECT AVE APT 3G, HACKENSACK, NJ 07601-1857
(201) 577-8494
Mailing address
170 PROSPECT AVE APT 3G, HACKENSACK, NJ 07601-1857
(201) 577-8494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR18787900
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NR15265100
NJ
Other
Enumeration date
08/05/2024
Last updated
05/07/2026
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