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General NPI Number Information
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NPI Number | 1568215028
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Entity Type | Individual
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Provider Name | JOELLE JUNGHYUN KWON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 341 HARRISON AVE
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City | BOSTON
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State | MA
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Zip | 02118-2265
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Country | US
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Telephone | 617-556-3922
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Fax |
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Provider Business Mailing Address
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Address Line | 101 MONMOUTH ST APT 415
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City | BROOKLINE
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State | MA
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Zip | 02446-5612
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Country | US
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Telephone | 720-291-7812
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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 | PH997199
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License Number State | MA
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