Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jason Kim

Individual provider Pharmacist · NPI 1558778100

Jason Kim is a Pharmacist in Bayside, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014
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Practice location Address checks out

21110 18th Ave Apt 1D
Bayside, NY 11360-1501
Phone: (917) 683-3384
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 059291 (NY)

Record details

NPI number1558778100
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 15, 2014
Last updated in NPPESDecember 8, 2021
Certification dateDecember 8, 2021
Mailing address21110 18th Ave Apt 1d, Bayside, NY 11360-1501

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