Healthcare Provider Details

I. General information

NPI: 1316860943
Provider Name (Legal Business Name): JINGXIU JIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

IV. Provider business mailing address

4517 161ST ST FL 2
FLUSHING NY
11358-3155
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073626
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: