Active NPI
Su Jin Wang, RPH
- Pharmacist
- Jamaica, NY
National Provider Identifier
1780908491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 030450-1
- Practice address
- 8268 164TH St
Jamaica, NY 11432-1121 - Phone
- (718) 883-3878
- Fax
- (718) 883-6122
- NPI assigned
- Mar 24, 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 | 030450-1 | NY | Primary |
Addresses
Primary practice location
8268 164TH St
Jamaica, NY 11432-1121
Mailing address
82-68 164 Street
Jamaica, NY 11432
Phone (718) 883-3878
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030450-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1780908491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82-68 164 STREET",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11432",
"telephone_number": "718-883-3878",
"fax_number": "718-883-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8268 164TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321121",
"telephone_number": "718-883-3878",
"fax_number": "718-883-6122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "SU JIN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-24",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "030450-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.