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NPI Code Detail

MEDICARE: YOON J. KONG PHARMD, BCGP

MEDICARE: YOON J. KONG PHARMD, BCGP
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
11835G0303XGeriatric Pharmacist018976VA
2183500000XPharmacist0202206506VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1185772OTHERNABP
2000000000OTHERVAFAIRFAX HEALTH CENTER PHARMACY FORT BELVIOR

General Provider Information

NPI Number : 1730746793
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOON J. KONG PHARMD, BCGP
Provider Business Mailing Address
First Line : 1910 TRUMPET CT
Second Line :
City : VIENNA
State : VA
Zip : 22182-3358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10580 ARROWHEAD DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-7301
Country : US
Telephone Number : 571-432-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2019
Last Update Date : 06/11/2019

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Directions to “ YOON J. KONG PHARMD, BCGP” Practice Location

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