Provider Demographics
NPI:1053633222
Name:DING, JEAN (BS PHARM, RPH)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:DING
Suffix:
Gender:F
Credentials:BS PHARM, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 175TH PL
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1626
Mailing Address - Country:US
Mailing Address - Phone:646-262-1794
Mailing Address - Fax:
Practice Address - Street 1:20414 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2217
Practice Address - Country:US
Practice Address - Phone:718-464-4066
Practice Address - Fax:718-468-3232
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25952183500000X
NYI045773-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist