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General NPI Number Information
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NPI Number | 1447811542
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Entity Type | Individual
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Provider Name | ESTHER JINKYUNG SEO
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 21 CHATSWORTH AVE
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City | LARCHMONT
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State | NY
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Zip | 10538-2903
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Country | US
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Telephone | 833-410-3914
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 PARSONS BLVD APT 7E
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City | FLUSHING
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State | NY
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Zip | 11354-2309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 062521
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License Number State | NY
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