Individual provider Active NPI

Susie S Chung

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1326370594
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
040242 Issued in NY
Practice address
1350 Huguenot Ave
Staten Island, NY 10312-5723
Phone
(917) 916-6033
Fax
(347) 562-4250
NPI assigned
Feb 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040242 NY Primary

Addresses

Primary practice location

1350 Huguenot Ave
Staten Island, NY 10312-5723

Mailing address

1350 Huguenot Ave
Staten Island, NY 10312-5723
Phone (917) 916-6033

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

State licenses

LicenseStateTypeSpecialty
040242NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1326370594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125723",
            "telephone_number": "917-916-6033",
            "fax_number": "347-562-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125723",
            "telephone_number": "917-916-6033",
            "fax_number": "347-562-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SUSIE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.