Active NPI
Peter Kim
- Pharmacist
- New York, NY
National Provider Identifier
1124492467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 060708
- Practice address
- 455 W 37TH St
New York, NY 10018-4081 - Phone
- (212) 643-6090
- Fax
- (212) 643-6094
- NPI assigned
- Nov 24, 2015
- 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 | 060708 | NY | Primary |
Addresses
Primary practice location
455 W 37TH St
New York, NY 10018-4081
Mailing address
854 8TH Ave
Apt 5B
New York, NY 10019-6203
Phone (847) 322-2345
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060708 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1124492467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "854 8TH AVE",
"address_2": "APT 5B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100196203",
"telephone_number": "847-322-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 W 37TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100184081",
"telephone_number": "212-643-6090",
"fax_number": "212-643-6094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PETER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-24",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "060708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.