JEANNIE S JOO (NPI# 1033550017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033550017 |
| Entity Type | Individual |
| Full Name | JEANNIE S JOO |
| Practice Address |
118 Broad Ave Suite N4 Palisades Park NJ 07650-2717 |
| Practice Telephone | 2019457222 |
| Practice Fax Number | 2019457222 |
| Mailing Telephone | 2019457222 |
| Mailing Fax Number | 2019457222 |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
28RJ00612 | NJ | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | LICENSE | 28RJ00612 | 01 |
| NJ | LICENSE | 28RS00398200 | 01 |
| Street Address |
118 BROAD AVE SUITE N4 |
| City | PALISADES PARK |
| State | NJ |
| Zip Code | 07650-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679671606 | 7 Aleftv, Inc. | Pharmacy | 118 Broad Ave, Suite N4, Palisades Park, NJ 07650-2717 | 2006-09-21 |
| 1730631466 | Hyeyoung Park | Nurse Practitioner | 118 Broad Ave, Ste N10, Palisades Park, NJ 07650-2717 | 2016-10-28 |
| 1588114060 | Prime Diagnostics, P.C. | Specialist | 118 Broad Ave, N9, Palisades Park, NJ 07650-2717 | 2016-10-10 |
| 1881057412 | Jaedoo Lee | Chiropractor | 118 Broad Ave, N9, Palisades Park, NJ 07650-2717 | 2016-03-31 |
| 1598168882 | Prime Diagnostics PC | Legal Medicine | 118 Broad Ave, Unit N9, Palisades Park, NJ 07650-2717 | 2014-10-01 |
| 1558774778 | Prime Acupuncture Care PC | Acupuncturist | 118 Broad Ave, Suite N10, Palisades Park, NJ 07650-2717 | 2014-06-05 |
| 1487067724 | Prime Chiropractic PC | Chiropractor | 118 Broad Ave, Suite N10, Palisades Park, NJ 07650-2717 | 2014-06-04 |
| 1437579505 | Prime Pain Clinic P.C. | Physical Therapist | 118 Broad Ave, Ste N10, Palisades Park, NJ 07650 | 2014-04-16 |
| 1134350648 | E-plant Dental, P.C. | Dentist | 118 Broad Ave, #n-10, Palisades Park, NJ 07650-2717 | 2009-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356902134 | Balance Dizziness Center Inc. | Psychiatry & Neurology | 17 Brinkerhoff Terrace, Palisades Park, NJ 07650 | 2019-06-24 |
| 1437631371 | Catherine Jang | Pharmacist | 113 Roosevelt Pl, Palisades Park, NJ 07650 | 2018-09-06 |
| 1063911782 | Jinwoo Kim | Acupuncturist | 58w Oakdene Ave, Unit A, Palisades Park, NJ 07650 | 2018-02-08 |
| 1275053563 | Prime Painmanagement PC | Physical Medicine & Rehabilitation | 118-126 Broad Avenue, Unit 11, Palisades Park, NJ 07650 | 2017-06-27 |
| 1366836520 | George Xenakis, Dds, Palisades Park, LLC | Clinic/Center | 261a Broad Ave, Palisades Park, NJ 07650 | 2015-03-26 |
| 1245637842 | Sun Young Lee | Nurse Practitioner | 11 West Harriet Ave, Apt 102, Palisades Park, NJ 07650 | 2014-11-25 |
| 1063824290 | Daehwan Ji | Acupuncturist | 460 Bergen Blvd Suite #304, Palisades Park, NJ 07650 | 2014-05-22 |
| 1295084739 | Minhyun Cho | Counselor | 19 E Central Blvd, Palisades Park, NJ 07650 | 2012-08-30 |
| 1255693164 | Juliana A Vasquez | Specialist | 446 7th Street, Palisades Park, NJ 07650 | 2012-06-15 |
| 1295019529 | Now Pain Clinc PC | Residential Treatment Facility, Physical Disabilities | 21 Grand Ave #502, Palisades Park, NJ 07650 | 2011-10-05 |
| Find all providers in zip 07650 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958856 | Pavan K Parimi | Pharmacist | 40 Spruce Meadows Dr, Monroe Township, NJ 08831-3103 | 2020-06-30 |
| 1841814837 | Jibi Philip | Pharmacist | 186 Larch Ave, Dumont, NJ 07628-1327 | 2020-06-04 |
| 1154804185 | Christopher Manuel Bregna | Pharmacist | 60 Fairview Dr, East Hanover, NJ 07936-3508 | 2018-09-14 |
| 1104308121 | Mahwish Zafar | Pharmacist | 1726 Route 37 E, Toms River, NJ 08753-8237 | 2018-09-06 |
| 1386126118 | Panagiota Kousoulis | Pharmacist | 41 Spring St, New Providence, NJ 07974-1143 | 2018-08-29 |
| 1619470606 | Dina Minisi | Pharmacist | 57 Harrowgate Dr, Cherry Hill, NJ 08003-1938 | 2018-03-15 |
| 1720509888 | Sandra Sparta | Pharmacist | 66 Claire Dr, Bridgewater, NJ 08807-1854 | 2017-06-29 |
| 1205377272 | Glatz Rx Consultants LLC | Pharmacist | 54 Broken Arrow Road, Medford, NJ 08055 | 2017-03-10 |
| 1255871745 | Charles W Glatz | Pharmacist | 54 Broken Arrow Bend, Medford, NJ 08055 | 2017-03-02 |
| 1669917613 | Legendary Care Consulting | Pharmacist | 19 Amelia St, North Caldwell, NJ 07006-4155 | 2016-12-30 |
| Find all providers with the same taxonomy | ||||
| City | PALISADES PARK |
| Zip Code | 07650 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.