Active NPI
Tai Ho Kim, R.PH.
- Pharmacist
- Mount Vernon, NY
National Provider Identifier
1396064580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 032563
- Practice address
- 32 Gramatan Ave
Mount Vernon, NY 10550-1306 - Phone
- (201) 983-3002
- NPI assigned
- May 27, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 032563 | NY | Primary |
Addresses
Primary practice location
32 Gramatan Ave
Mount Vernon, NY 10550-1306
Mailing address
267 Highland Ave
Palisades Park, NJ 07650-1135
Phone (201) 983-3002
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 |
|---|---|---|---|
| 032563 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1396064580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 HIGHLAND AVE",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501135",
"telephone_number": "201-983-3002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 GRAMATAN AVE",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105501306",
"telephone_number": "201-983-3002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAI",
"middle_name": "HO",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-27",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "032563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.