Johannes Kee Gunawan, R.PH
Individual provider Active NPI Pharmacist · Norwalk, TN
NPI 1003097320 · NPPES record last updated Nov 15, 2007
Key facts
- NPI
- 1003097320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 8699 (CT)
- Practice address
- 680 Connecticut Ave
Norwalk, TN 06854 - Phone
- (203) 854-8519
- Fax
- (203) 854-9526
- NPI assigned
- Nov 15, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8699 | CT | Yes |
Addresses
Primary practice location
680 Connecticut Ave
Norwalk, TN 06854
Mailing address
39 Monroe Street Apartment # 1
New York, NY 10002
Phone (917) 324-7337
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.