Active NPI
Mario I Kim, BS
- Pharmacist
- Freeport, NY
National Provider Identifier
1225247687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 046578
- Practice address
- 88 W Merrick Rd
Freeport, NY 11520-3710 - Phone
- (516) 377-8500
- Fax
- (516) 377-8501
- NPI assigned
- May 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 046578 | NY | Primary |
Addresses
Primary practice location
88 W Merrick Rd
Freeport, NY 11520-3710
Mailing address
6152 Little Neck Pkwy
Little Neck, NY 11362-2419
Phone (718) 631-8850
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 |
|---|---|---|---|
| 046578 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RNJ Pharmacy Inc. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225247687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6152 LITTLE NECK PKWY",
"city": "LITTLE NECK",
"state": "NY",
"postal_code": "113622419",
"telephone_number": "718-631-8850",
"fax_number": "718-631-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 W MERRICK RD",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115203710",
"telephone_number": "516-377-8500",
"fax_number": "516-377-8501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MARIO",
"middle_name": "I",
"name_prefix": "Mr.",
"credential": "BS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "046578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.