Individual provider · NPI-1

Hyon Jin Bae, FNP

Nurse Practitioner, Family · Stony Brook, NY

NPI number1215330717
StatusActive
Last updated in NPPESAug 8, 2022

Details

NPI
1215330717
Entity type
Individual (NPI-1)
Name
Ms. Hyon Jin Bae
Credential
FNP
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 29, 2014
Certification date
Aug 8, 2022
Last updated
Aug 8, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family350044NYYes

Practice location

101 Nicolls Rd
Stony Brook, NY 11794-0001

Phone 631-689-8333

Mailing address

181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495

Phone 631-444-5858

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