Active NPI
Yeonwoo Jung, PHARMD
- Pharmacist
- New York, NY
National Provider Identifier
1679942767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 060713-1
- Practice address
- 3363A Broadway
New York, NY 10031-7403 - Phone
- (212) 518-3010
- Fax
- (866) 280-3150
- NPI assigned
- Sep 18, 2015
- 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 | 060713-1 | NY | Primary |
Addresses
Primary practice location
3363A Broadway
New York, NY 10031-7403
Mailing address
4542 41St St Apt 1H
Sunnyside, NY 11104-3421
Phone (716) 545-6000
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 |
|---|---|---|---|
| 060713-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hilda Pharmacy LLC | Current | Accepting new patients |
Locations
3363 Broadway
#A
New York, NY 10031
Phone (212) 518-3010
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.
-
- Pharmacy
- New York, NY
- NPI 1376202192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1679942767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4542 41ST ST APT 1H",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111043421",
"telephone_number": "716-545-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3363A BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100317403",
"telephone_number": "212-518-3010",
"fax_number": "866-280-3150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "YEONWOO",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-18",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "060713-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.