Robert Kennedy Awadallah, PHARM.D, ANP, MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

046732-1 Issued in NY

Practice address

200 Belle Terre Rd
Port Jefferson, NY 11777-1968

Phone

(631) 474-6000

NPI assigned

Nov 7, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Pharmacy

State licenses

Practice roles

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.

• Clinical Pharmacy Consult, LLC

  • Pharmacy
  • Mineola, NY
  • NPI 1548406119
  NPD (past) Authorized official

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1043855596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 EVELYN RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013206",
            "telephone_number": "516-376-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771968",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWADALLAH",
        "first_name": "ROBERT",
        "middle_name": "KENNEDY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D, ANP, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "NY",
            "license": "046732-1",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "046732-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinonso Saviour Asuzu, DO
• Alyssa Sarah Atkins
• Hesham Mahmoud Atwa, M.D.
• Joseph M Audiino, P.A.
• Catherine Audus
• Lisa Aymong, NP
• Arvin Azam, DO
• Sundus Aziz, DO
• Holly Rose Azueta, RN
• Samantha Haley Baca

• Pharmacist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.