Active NPI
Silvia C Kim
- Pharmacist
- Ridgewood, NY
National Provider Identifier
1366774168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I054080-1
- Practice address
- 5411 Myrtle Ave
Ridgewood, NY 11385-3452 - Phone
- (718) 386-6692
- NPI assigned
- Feb 3, 2010
- Sex
- Female
- Sole proprietor
- No
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 | I054080-1 | NY | Primary |
| Pharmacist | 183500000X | 28RI03120700 | NJ |
Addresses
Primary practice location
5411 Myrtle Ave
Ridgewood, NY 11385-3452
Mailing address
54-11 Myrtle Ave
Ridgewood, NY 11385
Phone (718) 386-6692
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03120700 | NJ | MD | Pharmacist |
| I054080-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients | |
| Duane Reade | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1366774168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54-11 MYRTLE AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "11385",
"telephone_number": "718-386-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5411 MYRTLE AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853452",
"telephone_number": "718-386-6692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SILVIA",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-03",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I054080-1",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03120700",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.