Active NPI
Taehyun Kim, RPH
- Pharmacist
- Hollis, NY
National Provider Identifier
1811423148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 061609
- Practice address
- 8655 Palo Alto St
Hollis, NY 11423-1203 - Phone
- (201) 674-1012
- Fax
- (347) 809-2728
- NPI assigned
- May 5, 2017
- 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 | 061609 | NY | Primary |
Addresses
Primary practice location
8655 Palo Alto St
Hollis, NY 11423-1203
Mailing address
8655 Palo Alto St
Hollis, NY 11423-1203
Phone (201) 674-1012
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 |
|---|---|---|---|
| 061609 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylor's Pharmacy Inc. | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Great Neck, NY
- NPI 1740848084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586390400000",
"number": "1811423148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8655 PALO ALTO ST",
"city": "HOLLIS",
"state": "NY",
"postal_code": "114231203",
"telephone_number": "201-674-1012",
"fax_number": "347-809-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8655 PALO ALTO ST",
"city": "HOLLIS",
"state": "NY",
"postal_code": "114231203",
"telephone_number": "201-674-1012",
"fax_number": "347-809-2728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAEHYUN",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-05",
"last_updated": "2020-04-09",
"certification_date": "2020-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "061609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.