Jisup Han, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI03614100 Issued in NJ

Practice address

455 Livingston St Ste 4
Norwood, NJ 07648-1360

Phone

(201) 272-6224

Fax

(201) 272-6225

NPI assigned

May 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• K&J Pharmacy LLC

  • Community/Retail Pharmacy
  • Norwood, NJ
  • NPI 1679271233
  NPD Authorized official
• Jane Star Corporation

  • Community/Retail Pharmacy
  • Fort Lee, NJ
  • NPI 1497020242
  NPD (past)

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1467035691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 ANDERSON AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244469",
            "telephone_number": "201-224-8877",
            "fax_number": "201-224-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LIVINGSTON ST STE 4",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481360",
            "telephone_number": "201-272-6224",
            "fax_number": "201-272-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JISUP",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03614100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Faustini
• Fit to Go, LLC
• Matthew Lawrence Galfund, DDS
• Shaun Joseph Glover, OTR/L
• Karen Eileen Godgart, HIS
• Mina Han
• J Max Optics, Inc
• JG Medical Services LLC
• Jill Jonas, LCSW
• K&J Pharmacy LLC

• Pharmacist in Norwood, NJ
• Providers in Norwood, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.