Individual provider Active NPI

Evangeline Grimaldi, RPH

  • Pharmacist
  • Delmar, NY
National Provider Identifier
1003139981
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042922 Issued in NY
Practice address
340 Delaware Ave
Delmar, NY 12054-1978
Phone
(518) 439-8200
NPI assigned
Mar 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 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 042922 NY Primary

Addresses

Primary practice location

340 Delaware Ave
Delmar, NY 12054-1978

Mailing address

144 Spring Rd
Glenville, NY 12302-2721
Phone (518) 630-6021

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
042922NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1003139981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 SPRING RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123022721",
            "telephone_number": "518-630-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541978",
            "telephone_number": "518-439-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDI",
        "first_name": "EVANGELINE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delmar, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.