Active NPI
Soo-Yon R Mack, BS
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1033389044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 034571
- Practice address
- 1525 Albany Ave
Brooklyn, NY 11210-2018 - Phone
- (718) 859-2500
- Fax
- (718) 859-0598
- NPI assigned
- Mar 5, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 034571 | NY | Primary |
Addresses
Primary practice location
1525 Albany Ave
Brooklyn, NY 11210-2018
Mailing address
1525 Albany Ave
Brooklyn, NY 11210-2018
Phone (718) 859-2500
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034571 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathmark Stores Inc | Past | Accepting new patients | |
| Pathmark Stores Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1033389044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 ALBANY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102018",
"telephone_number": "718-859-2500",
"fax_number": "718-859-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 ALBANY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102018",
"telephone_number": "718-859-2500",
"fax_number": "718-859-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "SOO-YON",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "034571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.