Active NPI
Shul Hyung Park, R.PH
- Pharmacist
- Fort Lee, NJ
National Provider Identifier
1366793705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03514500
- Practice address
- 1400 Anderson Ave Unit 7
Fort Lee, NJ 07024-4405 - Phone
- (201) 224-8877
- NPI assigned
- Sep 25, 2012
- Last updated
- Sep 25, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03514500 | NJ | Primary |
Addresses
Primary practice location
1400 Anderson Ave Unit 7
Fort Lee, NJ 07024-4405
Mailing address
544B Glen Ave
Palisades Park, NJ 07650-1863
Phone (732) 718-9838
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 |
|---|---|---|---|
| 28RI03514500 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jane Star Corporation | Past | Accepting new patients |
Organizations & group practices 1
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": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1366793705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "544B GLEN AVE",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501863",
"telephone_number": "732-718-9838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 ANDERSON AVE UNIT 7",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070244405",
"telephone_number": "201-224-8877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SHUL HYUNG",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-25",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03514500",
"primary": true
}
],
"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 Sep 25, 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.