Provider Demographics
NPI:1093317067
Name:CHOI, KATIE JIYOUNG (PHARM D)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JIYOUNG
Last Name:CHOI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1230
Mailing Address - Country:US
Mailing Address - Phone:718-938-5751
Mailing Address - Fax:
Practice Address - Street 1:333 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1230
Practice Address - Country:US
Practice Address - Phone:718-938-5751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02953300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist