Individual provider Active NPI

Youngjoo Song

  • Pharmacist
  • Cohasset, MA
National Provider Identifier
1154209088
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1000774 Issued in MA
Practice address
790 Chief Justice Cushing Hwy
Cohasset, MA 02025-2140
Phone
(781) 383-1525
NPI assigned
Aug 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH1000774 MA Primary

Addresses

Primary practice location

790 Chief Justice Cushing Hwy
Cohasset, MA 02025-2140

Mailing address

790 Chief Justice Cushing Hwy
Cohasset, MA 02025-2140

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

LicenseStateTypeSpecialty
PH1000774MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1154209088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CHIEF JUSTICE CUSHING HWY",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020252140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHIEF JUSTICE CUSHING HWY",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020252140",
            "telephone_number": "781-383-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "YOUNGJOO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1000774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohasset, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.