Active NPI
Jia Min Polly Chen
- Pharmacist
- Fresh Meadows, NY
National Provider Identifier
1902215973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 059598
- Practice address
- 6962 188TH St
Fresh Meadows, NY 11365-3771 - Phone
- (917) 682-2508
- NPI assigned
- Aug 4, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 059598 | NY | Primary |
Addresses
Primary practice location
6962 188TH St
Fresh Meadows, NY 11365-3771
Mailing address
6962 188TH St
Fresh Meadows, NY 11365-3771
Phone (917) 682-2508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02717408 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059598 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1902215973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6962 188TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653771",
"telephone_number": "917-682-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6962 188TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653771",
"telephone_number": "917-682-2508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "JIA",
"middle_name": "MIN POLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-04",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "059598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02717408",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.