Active NPI
Hak Kyoung Kim
- Pharmacist
- Fresh Meadows, NY
National Provider Identifier
1912331026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 058421
- Practice address
- 19250A 71St Cres
Apt 1B
Fresh Meadows, NY 11365-4014 - Phone
- (201) 966-4916
- NPI assigned
- Aug 26, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 78286 | CA | |
| Pharmacist | 183500000X | 058421 | NY | Primary |
Addresses
Primary practice location
19250A 71St Cres
Apt 1B
Fresh Meadows, NY 11365-4014
Mailing address
3814 Pruneridge Ave
Santa Clara, CA 95051-5846
Phone (201) 966-4916
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 |
|---|---|---|---|
| 78286 | CA | MD | Pharmacist |
| 058421 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613174400000",
"number": "1912331026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3814 PRUNERIDGE AVE",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950515846",
"telephone_number": "201-966-4916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250A 71ST CRES",
"address_2": "APT 1B",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113654014",
"telephone_number": "201-966-4916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HAK KYOUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-26",
"last_updated": "2021-02-13",
"certification_date": "2021-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "78286",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "058421",
"primary": true
}
],
"identifiers": [],
"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 Feb 13, 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.