Joseph Kim, PHARMD
Individual provider Active NPI Pharmacist · Riverside, CT
NPI 1770064792 · NPPES record last updated Aug 27, 2018
Key facts
- NPI
- 1770064792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PCT.0014045 (CT)
- Practice address
- 1333 E Putnam Ave
Riverside, CT 06878-1529 - Phone
- (203) 637-1496
- NPI assigned
- Aug 27, 2018
- Sex
- Male
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0014045 | CT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0014045 | CT | Yes |
Addresses
Primary practice location
1333 E Putnam Ave
Riverside, CT 06878-1529
Mailing address
1333 E Putnam Ave
Riverside, CT 06878-1529
Other providers in Riverside, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.