Omar Korban

Primary specialty

PharmacistTaxonomy code 183500000X

License

068787 Issued in NY

Practice address

3454 Junction Blvd
Jackson Heights, NY 11372-3829

Phone

(718) 565-1005

Fax

(718) 565-1004

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Corona Hub Inc

  • Community/Retail Pharmacy
  • Corona, NY
  • NPI 1346003134
  NPD Authorized official
• Queens Express Pharmacy Corp

  • Community/Retail Pharmacy
  • Jackson Heights, NY
  • NPI 1649448143
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1972258598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SOUNDVIEW LN APT A",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113561167",
            "telephone_number": "347-606-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 JUNCTION BLVD",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723829",
            "telephone_number": "718-565-1005",
            "fax_number": "718-565-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBAN",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Lyn Kmiotek, LMSW
• Roxanne Leilani Ko, MD
• Sharona Kohan, OD
• Jun Phaik Quah Kong, M.S., CCC-SLP
• Dominique Koonce
• Zuzanna Korczyc
• Caroline Koslosky, DDS
• Ilha Kostyuchenko
• Anne Beckert Kuchins, GNP
• Nanjundaiah Kumar, MD

• Pharmacist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.