Active NPI
Grace Song Kwon, RPH
- Pharmacist
- Yonkers, NY
National Provider Identifier
1023330354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30872
- Practice address
- 491 S Broadway
Yonkers, NY 10705-3252 - Phone
- (914) 963-3911
- Fax
- (914) 963-0800
- NPI assigned
- Mar 1, 2010
- Last updated
- Jun 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30872 | NY | Primary |
Addresses
Primary practice location
491 S Broadway
Yonkers, NY 10705-3252
Mailing address
491 S Broadway
Yonkers, NY 10705-3252
Phone (914) 963-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30872 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Pharmacy LTD. | Pharmacist | Current | Accepting new patients |
Locations
491 S Broadway
Yonkers, NY 10705
Phone (914) 963-3911
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1023330354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "491 S BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107053252",
"telephone_number": "914-963-3911",
"fax_number": "914-963-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "491 S BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107053252",
"telephone_number": "914-963-3911",
"fax_number": "914-963-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "GRACE",
"middle_name": "SONG",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-01",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "30872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.