Healthcare Provider Details

I. General information

NPI: 1316856149
Provider Name (Legal Business Name): JIWON CHOI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 CANAL ST
STAMFORD CT
06902-5901
US

IV. Provider business mailing address

537 CANAL ST
STAMFORD CT
06902-5901
US

V. Phone/Fax

Practice location:
  • Phone: 203-323-1293
  • Fax:
Mailing address:
  • Phone: 203-323-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0017430
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: