=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063814945
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ESTHER HEEWON CHOI PHARM.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2014
-----------------------------------------------------
Last Update Date | 02/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15626 NORTHERN BLVD
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-661-4440
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16705 12TH AVE APT 8B
-----------------------------------------------------
City | BEECHHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11357-2208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-247-4332
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 059865
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------