Active NPI
Da Kyung Lee
- Pharmacist
- Leonia, NJ
National Provider Identifier
1922794817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04301500
- Practice address
- 305 Broad Ave
Leonia, NJ 07605-1826 - Phone
- (201) 849-5157
- NPI assigned
- Apr 13, 2023
- Last updated
- Apr 13, 2023
- 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 | 28RI04301500 | NJ | Primary |
Addresses
Primary practice location
305 Broad Ave
Leonia, NJ 07605-1826
Mailing address
1504 15TH St Unit C
Fort Lee, NJ 07024-2134
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 |
|---|---|---|---|
| 28RI04301500 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leonia Pharmacy LLC | Past | 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
- Leonia, NJ
- NPI 1053881268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1922794817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 15TH ST UNIT C",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070242134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 BROAD AVE",
"city": "LEONIA",
"state": "NJ",
"postal_code": "076051826",
"telephone_number": "201-849-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DA KYUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-13",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04301500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leonia, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.