Active NPI
Kyong Il Yu, RPH
- Pharmacist
- Fort Lee, NJ
National Provider Identifier
1306082813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045031
- Practice address
- 1400 Anderson Ave
Fortlee, NJ 07024-4405 - Phone
- (201) 224-8877
- Fax
- (201) 224-8871
- NPI assigned
- Jan 5, 2009
- Last updated
- Mar 22, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 045031 | NY | Primary |
| Pharmacist | 183500000X | 28RI03343800 | NJ |
Addresses
Primary practice location
1400 Anderson Ave
Fortlee, NJ 07024-4405
Mailing address
112 Ehret Ave
Harrington Park, NJ 07640
Phone (646) 996-9503
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
| License | State | Type | Specialty |
|---|---|---|---|
| 045031 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sol Pharmacy Inc | Current | Accepting new patients | |
| K&J Pharmacy LLC | Current | Accepting new patients | |
| Jane Star Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Palisades Park, NJ
- NPI 1659760783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332374400000",
"number": "1306082813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 EHRET AVE",
"city": "HARRINGTON PARK",
"state": "NJ",
"postal_code": "07640",
"telephone_number": "646-996-9503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 ANDERSON AVE",
"city": "FORTLEE",
"state": "NJ",
"postal_code": "070244405",
"telephone_number": "201-224-8877",
"fax_number": "201-224-8871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU",
"first_name": "KYONG IL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-05",
"last_updated": "2012-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045031",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03343800",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.