Carson Brady, PHARM.D.
Individual provider Active NPI Pharmacist · Vails Gate, NY
NPI 1003219726 · NPPES record last updated Oct 8, 2014
Key facts
- NPI
- 1003219726
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 059279 (NY)
- Practice address
- 384 Windsor Highway
Vails Gate, NY 12553 - Phone
- (845) 863-1054
- NPI assigned
- Oct 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059279 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 059279 | NY | Yes |
Addresses
Primary practice location
384 Windsor Highway
Vails Gate, NY 12553
Mailing address
16 John St
South Glens Falls, NY 12803-5214
Other providers in Vails Gate, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.