Waldbaum Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

025839 Issued in NY

Legal business name

WALDBAUM INC

Doing business as

Waldbaums Pharmacy

Practice address

1960 Deer Park Ave
Deer Park, NY 11729-3327

Phone

(631) 242-0951

Fax

(631) 242-5815

NPI assigned

Jul 13, 2006

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INCAs reported in NPPES

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

Authorized official

Name

Susan Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• WALDBAUMS PHARMACY Doing business as

Part of

The Great Atlantic Pacific Tea Co Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Great Atlantic & Pacific Tea Company Inc

  dba A & P Pharmacy

  • Pharmacy
  • Fairview, NJ
  • NPI 1518982172

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Alan Shapiro, R.PH

  • Pharmacist
  • Deer Park, NY
  • NPI 1811165582
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1003831561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293327",
            "telephone_number": "631-242-0951",
            "fax_number": "631-242-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDBAUM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "025839",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "025839",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "02386767",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02386767",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3330747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDBAUMS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christeen Vines
• Dianne Lorraine Vogel, MA
• Lorna A. Vopat, M.S.ED
• VT's Abc Inc.
• Alix Walczuk, MS
• Walgreen Co (Walgreens #05439)
• Joanne Walker, M.S., CCC, SLP
• Jennifer J Walsh, R.D.,CDN
• Lauren P Wamp
• Eloise Ward

• Pharmacy in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.