Dae Kwon, PHARMD RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

065041 Issued in NY

Practice address

995 Route 22
Brewster, NY 10509-1526

Phone

(845) 940-1111

NPI assigned

Jun 23, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

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 Health Pharmacy LLC

  dba Community Health Pharmacy

  • Community/Retail Pharmacy
  • New Haven, CT
  • NPI 1578012324
  NPD (past)

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1538689237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WILLOW DR",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545102",
            "telephone_number": "917-881-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105091526",
            "telephone_number": "845-940-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Dixwell Ave",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065113416",
            "country_code": "US",
            "telephone_number": "203-498-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Arch St",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060512520",
            "country_code": "US",
            "telephone_number": "860-255-9000",
            "fax_number": "860-255-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15015 Northern Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113543885",
            "country_code": "US",
            "telephone_number": "718-888-0851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "DAE",
        "credential": "PHARMD RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "065041",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "PCT.0013768",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RI04079800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Manusama Mental Health Counseling PLLC
• Dawn Kubilus, RN
• Megan Kuklevsky
• Allison Kurtz
• Valerie Kurtz
• Claudia Lampel, MD
• Lauren Ashley Lanzetta
• Agnes Larbi-Aggrey, MSW
• Kristy M Latella, MASTERS
• Barbara Ann Latterner, IBCLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Brewster, NY
• Providers in Brewster, NY by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.

Verify at the official NPI Registry.