Active NPI
Jiyoung Lee
- Pharmacist
- Fort Lee, NJ
National Provider Identifier
1396453841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04281900
- Practice address
- 1475 Bergen Blvd
Fort Lee, NJ 07024-2176 - Phone
- (201) 947-4840
- NPI assigned
- Nov 14, 2022
- Sex
- Female
- 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 | 28RI04281900 | NJ | Primary |
Addresses
Primary practice location
1475 Bergen Blvd
Fort Lee, NJ 07024-2176
Mailing address
22 Phelps Ave
Cresskill, NJ 07626-2525
Phone (781) 686-8821
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 |
|---|---|---|---|
| 28RI04281900 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1396453841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PHELPS AVE",
"city": "CRESSKILL",
"state": "NJ",
"postal_code": "076262525",
"telephone_number": "781-686-8821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 BERGEN BLVD",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070242176",
"telephone_number": "201-947-4840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JIYOUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04281900",
"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 Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.