Active NPI
Kathleen Ann Fama, RPH
- Pharmacist
- Latham, NY
National Provider Identifier
1033393095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 038074
- Practice address
- 933 Loudon Rd
Latham, NY 12110 - Phone
- (518) 783-1551
- NPI assigned
- Dec 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 038074 | NY | Primary |
Addresses
Primary practice location
933 Loudon Rd
Latham, NY 12110
Mailing address
23 Baldwin Court
Clifton Park, NY 12065
Phone (518) 383-0337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00483665 | Medicaid | NY |
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 |
|---|---|---|---|
| 038074 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1033393095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 BALDWIN COURT",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "12065",
"telephone_number": "518-383-0337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 LOUDON RD",
"city": "LATHAM",
"state": "NY",
"postal_code": "12110",
"telephone_number": "518-783-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAMA",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-26",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "038074",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00483665",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.