Active NPI
Tracey Hodurski, RPH
- Pharmacist
- Baldwin, NY
National Provider Identifier
1023628781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 043713
- Practice address
- 3278 Bertha Dr
Baldwin, NY 11510-5001 - Phone
- (516) 761-7040
- NPI assigned
- Aug 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 043713 | NY | Primary |
Addresses
Primary practice location
3278 Bertha Dr
Baldwin, NY 11510-5001
Mailing address
3278 Bertha Dr
Baldwin, NY 11510-5001
Phone (516) 761-7040
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
| License | State | Type | Specialty |
|---|---|---|---|
| 043713 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1023628781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3278 BERTHA DR",
"city": "BALDWIN",
"state": "NY",
"postal_code": "115105001",
"telephone_number": "516-761-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3278 BERTHA DR",
"city": "BALDWIN",
"state": "NY",
"postal_code": "115105001",
"telephone_number": "516-761-7040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODURSKI",
"first_name": "TRACEY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-06",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "043713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.