Active NPI
Eunkyung Lee
- Pharmacist
- Woodbridge, VA
National Provider Identifier
1508466384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202207059
- Practice address
- 14000 Worth Ave
Woodbridge, VA 22192-4121 - Phone
- (703) 497-2690
- NPI assigned
- Oct 29, 2020
- 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 | 0202207059 | VA | Primary |
Addresses
Primary practice location
14000 Worth Ave
Woodbridge, VA 22192-4121
Mailing address
5626 Kyle Dr
Centreville, VA 20120-1993
Phone (703) 587-4626
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 |
|---|---|---|---|
| 0202207059 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1508466384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5626 KYLE DR",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201201993",
"telephone_number": "703-587-4626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14000 WORTH AVE",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924121",
"telephone_number": "703-497-2690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "EUNKYUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-29",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202207059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.