Individual provider Active NPI

Jennifer Sue Sunukjian, RPH

  • Pharmacist
  • Elizabethtown, NY
National Provider Identifier
1255742128
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
048092-1 Issued in NY
Practice address
7550 Court Street
Elizabethtown, NY 12932
Phone
(518) 873-6441
Fax
(518) 873-9535
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048092-1 NY Primary

Addresses

Primary practice location

7550 Court Street
Elizabethtown, NY 12932

Mailing address

7550 Court St
Elizabethtown, NY 12932
Phone (518) 873-6441

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
048092-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KPH Healthcare Services, Inc. PastSince Jun 18, 2023 Accepting new patients
KPH Healthcare Services, Inc. PastSince Jun 18, 2023 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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1255742128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 COURT ST",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "12932",
            "telephone_number": "518-873-6441",
            "fax_number": "518-873-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 COURT STREET",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "12932",
            "telephone_number": "518-873-6441",
            "fax_number": "518-873-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNUKJIAN",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048092-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.