Individual provider Active NPI

Stefanie Portella, R.PH.

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1013129121
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036201 Issued in NY
Practice address
2758 Gerritsen Ave
Brooklyn, NY 11229-5915
Phone
(718) 332-7155
Fax
(718) 648-5482
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 036201 NY Primary

Addresses

Primary practice location

2758 Gerritsen Ave
Brooklyn, NY 11229-5915

Mailing address

16027 89TH St
Howard Beach, NY 11414-3410
Phone (718) 843-7458

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marine Pharmacy Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013129121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16027 89TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143410",
            "telephone_number": "718-843-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2758 GERRITSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295915",
            "telephone_number": "718-332-7155",
            "fax_number": "718-648-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELLA",
        "first_name": "STEFANIE",
        "name_prefix": "Ms.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

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