Individual provider Active NPI

Judith A Faris, RPH

  • Pharmacist
  • North Bellmore, NY
National Provider Identifier
1053593061
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
029164 Issued in NY
Practice address
1154 Peapond Rd
North Bellmore, NY 11710-2914
Phone
(516) 781-6074
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 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 029164 NY Primary

Addresses

Primary practice location

1154 Peapond Rd
North Bellmore, NY 11710-2914

Mailing address

1154 Peapond Rd
North Bellmore, NY 11710-2914
Phone (516) 781-6074

Other identifiers 1

IdentifierTypeStateIssuer
1275642761MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1053593061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 PEAPOND RD",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102914",
            "telephone_number": "516-781-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 PEAPOND RD",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102914",
            "telephone_number": "516-781-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIS",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "029164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275642761",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.