Seoungjun Chang, PHARMD

Individual provider Active NPI Pharmacist · Oakland Gardens, NY

NPI 1760142137 · NPPES record last updated Dec 27, 2021

Key facts

NPI
1760142137
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
068611 (NY)
Practice address
6129 Springfield Blvd
Oakland Gardens, NY 11364-2335
Phone
(631) 575-8278
NPI assigned
Dec 27, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
068611NYMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 068611 NY Yes

Addresses

Primary practice location

6129 Springfield Blvd
Oakland Gardens, NY 11364-2335

Mailing address

6129 Springfield Blvd
Oakland Gardens, NY 11364-2335
Phone (631) 575-8278

Other providers in Oakland Gardens, NY

All providers in Oakland Gardens, NY · Pharmacist in New York

Sources for this page

Verify at the official NPI Registry.