Active NPI
James Jiwon Song, PHARM.D.
- Pharmacist
- Woodbury, NY
National Provider Identifier
1265031256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 068797
- Practice address
- 333 Crossways Park Dr
Woodbury, NY 11797-2066 - Phone
- (631) 321-3850
- NPI assigned
- Oct 20, 2020
- Last updated
- Feb 20, 2025
- 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 | 068797 | NY | Primary |
Addresses
Primary practice location
333 Crossways Park Dr
Woodbury, NY 11797-2066
Mailing address
5624 220TH St
Bayside Hills, NY 11364-1934
Phone (917) 886-5416
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 |
|---|---|---|---|
| 068797 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | 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": "1603152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1265031256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5624 220TH ST",
"city": "BAYSIDE HILLS",
"state": "NY",
"postal_code": "113641934",
"telephone_number": "917-886-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 CROSSWAYS PARK DR",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972066",
"telephone_number": "631-321-3850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "JAMES",
"middle_name": "JIWON",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-20",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "068797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.