Jeong In Park, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI02461600 Issued in NJ

Practice address

2182 Lemoine Ave
Fort Lee, NJ 07024-6009

Phone

(120) 154-3864

Fax

(201) 482-4905

NPI assigned

Jan 8, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Well Mart & Pharmacy LLC

  • Community/Retail Pharmacy
  • Fort Lee, NJ
  • NPI 1053917583
  NPD Authorized official
• Edison Nephrorlogy Consultants

  • Specialist
  • Edison, NJ
  • NPI 1306926159
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1801484480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2182 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246009",
            "telephone_number": "201-482-4705",
            "fax_number": "201-482-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2182 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246009",
            "telephone_number": "120-154-3864",
            "fax_number": "201-482-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEONG",
        "middle_name": "IN",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02461600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF PHARMACY",
            "identifier": "28RI02461600",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": ".doc",
            "address_1": "2182 Lemoine Ave",
            "city": "Fort Lee",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070246009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Haeri Park
• Hyewon Park
• Hyun Joo Park, DPT
• Inhyon Park, D.C, L.AC
• Insun Park, D.C.
• Jihye Park, DDS
• Jonghee Park
• Jung Chul Park
• Margaret Chu Park, D.M.D.
• Samue C. Park, D.C.

• Pharmacist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.