Individual
DERRICK PYOMIN JEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4466
(551) 996-0969
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4466
(551) 996-0969
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA11433700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2019
Last updated
06/15/2022
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