MEDICARE: INSOON SHIN R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	051244	NY

General Provider Information

NPI Number	:	1144408709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INSOON SHIN R.PH

Provider Business Mailing Address
First Line	:	3632 UNION ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-4287
Country	:	US
Telephone Number	:	718-961-6010
Fax Number	:	718-358-9221

Provider Business Practice Location Address
First Line	:	3632 UNION ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-4287
Country	:	US
Telephone Number	:	718-961-6010
Fax Number	:	718-358-9221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	06/01/2026

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Directions to “ INSOON SHIN R.PH” Practice Location

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