Individual provider Active NPI

Ketty Gracia, RPH

  • Pharmacist
  • Mamaroneck, NY
National Provider Identifier
1003139205
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042743 Issued in NY
Practice address
275 Mamaroneck Ave
Mamaroneck, NY 10543-2602
Phone
(914) 381-4550
Fax
(914) 381-2521
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 042743 NY Primary

Addresses

Primary practice location

275 Mamaroneck Ave
Mamaroneck, NY 10543-2602

Mailing address

1 Ogden Ave
White Plains, NY 10605-2305
Phone (914) 831-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
042743NYMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1003139205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OGDEN AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052305",
            "telephone_number": "914-831-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMARONECK AVE",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105432602",
            "telephone_number": "914-381-4550",
            "fax_number": "914-381-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIA",
        "first_name": "KETTY",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.