Active NPI
Benjamin Min Hyun Donovan, PHARMD
- Pharmacist
- Jamaica, NY
National Provider Identifier
1225639727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067335
- Practice address
- 12704 Guy R Brewer Blvd
Jamaica, NY 11434-2955 - Phone
- (718) 978-4485
- NPI assigned
- Nov 3, 2020
- Last updated
- Aug 10, 2024
- 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 | 067335 | NY | Primary |
Addresses
Primary practice location
12704 Guy R Brewer Blvd
Jamaica, NY 11434-2955
Mailing address
29 Lakeside Dr
Rockville Centre, NY 11570-2309
Phone (516) 521-2449
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
| License | State | Type | Specialty |
|---|---|---|---|
| 067335 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Organizations & group practices 2
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": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723248000000",
"number": "1225639727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 LAKESIDE DR",
"city": "ROCKVILLE CENTRE",
"state": "NY",
"postal_code": "115702309",
"telephone_number": "516-521-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12704 GUY R BREWER BLVD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114342955",
"telephone_number": "718-978-4485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "BENJAMIN",
"middle_name": "MIN HYUN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-03",
"last_updated": "2024-08-10",
"certification_date": "2024-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.