Provider Demographics
NPI:1508172149
Name:LIM, LIMON SEUNGJIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LIMON
Middle Name:SEUNGJIN
Last Name:LIM
Suffix:
Gender:M
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 1:600 ALA MOANA BLVD APT 3207
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4967
Mailing Address - Country:US
Mailing Address - Phone:718-404-6440
Mailing Address - Fax:
Practice Address - Street 1:13602 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:718-886-3212
Practice Address - Fax:718-886-9195
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054962183500000X
HIPH-4188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist