MEDICARE: JASMINE OH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	066269	NY

General Provider Information

NPI Number	:	1659212389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE OH

Provider Business Mailing Address
First Line	:	4441 PURVES ST APT 1309
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2988
Country	:	US
Telephone Number	:	530-304-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	13341 ROOSEVELT AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5254
Country	:	US
Telephone Number	:	917-908-0618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ JASMINE OH ” Practice Location

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