Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

016026 Issued in NY

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

1757 Central Park Ave
Yonkers, NY 10710-2828

Phone

(914) 961-2355

Fax

(914) 779-4071

NPI assigned

Sep 20, 2006

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC & PACIFIC TEA CO INCAs reported in NPPES

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

Authorized official

Name

Susan D Kijowski

Title

Manager, Regulatory Compliance

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna G Antiaris

  • Pharmacist
  • Yonkers, NY
  • NPI 1982873840
  NPD (past)
• James S. Cazilas, R.PH.

  • Pharmacist
  • Yonkers, NY
  • NPI 1851569446
  NPD (past)
• Allen Shane, RPH

  • Pharmacist
  • Yonkers, NY
  • NPI 1255331260
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1053418822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700",
            "fax_number": "201-571-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 CENTRAL PARK AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107102828",
            "telephone_number": "914-961-2355",
            "fax_number": "914-779-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO INC",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER, REGULATORY COMPLIANCE",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "016026",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "016026",
            "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3364178",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00502727",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachna Patel, RPH
• Reena Patel, M.S.
• Rima Dipak Patel, M.D.
• Sapan Patel, DO
• Trini Anthony Ayson Pateno, PT
• Pathmark Stores Inc (Pathmark Pharmacy)
• Patois Republic LLC
• Todd C Patton, MD
• Paul J Gunser, Psy.D., P.C.
• Paul S Pickholtz MD PC

• Pharmacy in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.