Active NPI
Yeong Ae Kim, PHARM. D
- Pharmacist
- Staten Island, NY
National Provider Identifier
1649593765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053092
- Practice address
- 1973 Forest Ave
Staten Island, NY 10303-2104 - Phone
- (718) 448-1782
- Fax
- (718) 449-4949
- NPI assigned
- Mar 3, 2010
- 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 | 053092 | NY | Primary |
Addresses
Primary practice location
1973 Forest Ave
Staten Island, NY 10303-2104
Mailing address
1973 Forest Ave
Staten Island, NY 10303-2104
Phone (718) 448-1782
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053092 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1649593765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1973 FOREST AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103032104",
"telephone_number": "718-448-1782",
"fax_number": "718-449-4949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1973 FOREST AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103032104",
"telephone_number": "718-448-1782",
"fax_number": "718-449-4949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YEONG",
"middle_name": "AE",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-03",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
- Jasmine Kim
- Junghyun Kim
- Kenneth Kim, RN
- Kyung Sook Kim, FNP
- Minah Kim, DDS
- Kind Hearts Applied Behavior Analysis, PC
- Kindheart Connections, Inc.
- Kinetix Physical Therapy PC (Refuah Physical Therapy)
- King Kullen Pharmacies Corp (King Kullen Pharmacy)
- King Kullen Pharmacies Corp (King Kullen Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.