Individual provider Active NPI

Inna Yeselson, PHARMACIST

  • Pharmacist
  • Freehold, NJ
National Provider Identifier
1063737575
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RS00698600 Issued in NJ
Practice address
901 West Main Street
Suite 162
Freehold, NJ 07728
Phone
(732) 414-1977
NPI assigned
Mar 29, 2010
Last updated
Mar 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RS00698600 NJ Primary

Addresses

Primary practice location

901 West Main Street
Suite 162
Freehold, NJ 07728

Mailing address

1481 Arden Ave
Staten Island, NY 10312-5407
Phone (718) 966-4405

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

State licenses

LicenseStateTypeSpecialty
28RS00698600NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Freehold Specialty Pharmacy LLC Past Accepting new patients
Neuroscience Clinical Research Medical PC Past Accepting new patients
Specialty Script Freehold LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1063737575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 ARDEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125407",
            "telephone_number": "718-966-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WEST MAIN STREET",
            "address_2": "SUITE 162",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-414-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESELSON",
        "first_name": "INNA",
        "name_prefix": "Mrs.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RS00698600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.