Healthcare Provider Details

I. General information

NPI: 1053633222
Provider Name (Legal Business Name): JEAN DING B.S. PHARM., RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2010
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6822 FRESH MEADOW LN
FRESH MEADOWS NY
11365-3421
US

IV. Provider business mailing address

5032 175TH PL
FRESH MEADOWS NY
11365-1626
US

V. Phone/Fax

Practice location:
  • Phone: 917-477-0070
  • Fax: 917-477-0074
Mailing address:
  • Phone: 646-262-1794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25952
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI045773-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: