Active NPI
Sang Yong Ahn
- Pharmacist
- Jersey City, NJ
National Provider Identifier
1477147692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI0400340
- Practice address
- 492 Central Ave
Jersey City, NJ 07307-2646 - Phone
- (201) 716-2568
- NPI assigned
- Feb 28, 2021
- 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 | 28RI0400340 | NJ | Primary |
Addresses
Primary practice location
492 Central Ave
Jersey City, NJ 07307-2646
Mailing address
883 US Highway 1
Edison, NJ 08817-4677
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 |
|---|---|---|---|
| 28RI0400340 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Differx Pharmacy LLC | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Jersey City, NJ
- NPI 1982109880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1477147692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "883 US HIGHWAY 1",
"city": "EDISON",
"state": "NJ",
"postal_code": "088174677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "492 CENTRAL AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073072646",
"telephone_number": "201-716-2568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "SANG YONG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-28",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI0400340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.