Healthcare Provider Details

I. General information

NPI: 1790625929
Provider Name (Legal Business Name): RACHEL EUN WI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 UTOPIA PKWY
WHITESTONE NY
11357-4131
US

IV. Provider business mailing address

1923 UTOPIA PKWY
WHITESTONE NY
11357-4131
US

V. Phone/Fax

Practice location:
  • Phone: 718-767-4854
  • Fax:
Mailing address:
  • Phone: 718-767-4854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073714
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: