Active NPI
Ji Myung Kim
- Pharmacy
- Palisades Park, NJ
National Provider Identifier
1851984975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Practice address
- 450 Broad Ave
Palisades Park, NJ 07650-1631 - Phone
- (201) 947-8877
- NPI assigned
- Feb 19, 2021
- Last updated
- Feb 19, 2021
- 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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
450 Broad Ave
Palisades Park, NJ 07650-1631
Mailing address
230 A 3Rd Street
Basement
Palisades Park, NJ 07650
Phone (857) 409-1374
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613692800000",
"number": "1851984975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 A 3RD STREET",
"address_2": "BASEMENT",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "07650",
"telephone_number": "857-409-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 BROAD AVE",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501631",
"telephone_number": "201-947-8877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JI MYUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2021-02-19",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palisades Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.