Individual provider Active NPI

Carla M Blasi, RPH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1063695641
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
034640-1 Issued in NY
Practice address
5027 New Utrecht Ave
Brooklyn, NY 11219-3547
Phone
(718) 431-8000
Fax
(718) 431-8943
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 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 034640-1 NY Primary

Addresses

Primary practice location

5027 New Utrecht Ave
Brooklyn, NY 11219-3547

Mailing address

3310 Avenue T
1St Floor
Brooklyn, NY 11234-4911
Phone (347) 791-7283

Other identifiers 2

IdentifierTypeStateIssuer
1750322657OtherNYNPI
02709626MedicaidNY

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

LicenseStateTypeSpecialty
034640-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1063695641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 AVENUE T",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344911",
            "telephone_number": "347-791-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5027 NEW UTRECHT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193547",
            "telephone_number": "718-431-8000",
            "fax_number": "718-431-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASI",
        "first_name": "CARLA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "034640-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750322657",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02709626",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.