Chong C. Pak, RPH
Individual provider Active NPI Pharmacist · Rivervale, NJ
NPI 1174842983 · NPPES record last updated May 19, 2010
Key facts
- NPI
- 1174842983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI02501400 (NJ)
- Practice address
- 654 Westwood Ave
Rivervale, NJ 07675-6256 - Phone
- (201) 664-6900
- Fax
- (201) 664-9058
- NPI assigned
- May 19, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02501400 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02501400 | NJ | Yes |
Addresses
Primary practice location
654 Westwood Ave
Rivervale, NJ 07675-6256
Mailing address
654 Westwood Ave
Rivervale, NJ 07675-6256
Phone (201) 664-6900
Other names
- Mr. Alex-Chong Pak
Other providers in Rivervale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.