Active NPI
Brian Jung
- Pharmacist
- Syosset, NY
National Provider Identifier
1568641140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044057
- Practice address
- 17 Michael Rd
Syosset, NY 11791-6401 - Phone
- (516) 681-7454
- NPI assigned
- Oct 30, 2007
- 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 | 044057 | NY | Primary |
Addresses
Primary practice location
17 Michael Rd
Syosset, NY 11791-6401
Mailing address
200 Sunrise Mall
Massapequa, NY 11758-4340
Phone (516) 799-5042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02393259 | Medicaid | NY |
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 |
|---|---|---|---|
| 044057 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1568641140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SUNRISE MALL",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117584340",
"telephone_number": "516-799-5042",
"fax_number": "516-799-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 MICHAEL RD",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117916401",
"telephone_number": "516-681-7454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-30",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "044057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02393259",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.