Individual provider Active NPI

Min Jung Lee, PHARM D.

  • Pharmacist
  • Englewood, NJ
National Provider Identifier
1124334263
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03859300 Issued in NJ
Practice address
10 W Palisade Ave
Englewood, NJ 07631-2709
Phone
(201) 541-5513
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP445009 PA
Pharmacist 183500000X 28RI03859300 NJ Primary

Addresses

Primary practice location

10 W Palisade Ave
Englewood, NJ 07631-2709

Mailing address

164 W Chelten Ave
Philadelphia, PA 19144-3302

Other practice location 1

164 W Chelten Ave
Philadelphia, PA 19144-3302
Phone (215) 438-5167

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03859300NJMDPharmacist
RP445009PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey CVS Pharmacy LLC CurrentSince Dec 13, 2022 Accepting new patients
Rite Aid of Pennsylvania LLC Past Accepting new patients
Rite Aid of Pennsylvania LLC Past Accepting new patients
New Jersey CVS Pharmacy LLC PastSince Dec 13, 2022 Accepting new patients

Locations

10 W Palisade Ave
Englewood, NJ 07631
Phone (201) 206-8591

Organizations & group practices 4

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1124334263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W CHELTEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312709",
            "telephone_number": "201-541-5513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 W Chelten Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191443302",
            "country_code": "US",
            "telephone_number": "215-438-5167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIN JUNG",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP445009",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03859300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.