Jisoo Park

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP459626 Issued in PA

Practice address

250 S Courtland St
East Stroudsburg, PA 18301-2807

Phone

(570) 424-0830

NPI assigned

Oct 22, 2025

Sex

Female

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

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.

• Pennsylvania CVS Pharmacy, L.L.C.

  • Pharmacy
  • East Stroudsburg, PA
  • NPI 1548364391
  NPD (past)
• Pennsylvania CVS Pharmacy, L.L.C.

  • Pharmacy
  • West Chester, PA
  • NPI 1639063571
  NPD (past)

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1548137755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S COURTLAND ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S COURTLAND ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012807",
            "telephone_number": "570-424-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JISOO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP459626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kandia Natee Palmer, LMSW
• Natasha Palmer, D.O.
• Frantzddyn Pamphile
• Thomas Michael Papa, MD
• Joel Paradis, PA
• Christopher B Parker, ATC, EMT-B
• Dorothy B. Parker, LCSW
• Deirdre Parkinson, BCBA, LBS
• Miranda May Patches
• Dhweep Patel, DPT

• Pharmacist in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.