Active NPI
Jin H Chung
- Pharmacist
- Hicksville, NY
National Provider Identifier
1922320605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 48408
- Practice address
- 210 S Broadway
Hicksville, NY 11801-5002 - Phone
- (516) 433-2711
- Fax
- (512) 681-6422
- NPI assigned
- Feb 22, 2010
- Sex
- Male
- 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 | 48408 | NY | Primary |
Addresses
Primary practice location
210 S Broadway
Hicksville, NY 11801-5002
Mailing address
4120 Hempstead Tpke
Bethpage, NY 11714-5600
Phone (516) 520-8809
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 |
|---|---|---|---|
| 48408 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Hicksville, NY
- NPI 1942215017
-
- Pharmacy
- Brookhaven, PA
- NPI 1215942206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1922320605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4120 HEMPSTEAD TPKE",
"city": "BETHPAGE",
"state": "NY",
"postal_code": "117145600",
"telephone_number": "516-520-8809",
"fax_number": "516-520-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S BROADWAY",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118015002",
"telephone_number": "516-433-2711",
"fax_number": "512-681-6422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "JIN",
"middle_name": "H",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-22",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "48408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.