Tina M Small, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP041390L Issued in PA

Practice address

3400 Spruce St
Ravdin1
Philadelphia, PA 19104-4206

Phone

(215) 662-2920

NPI assigned

Mar 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1073783080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PICKET POST LN",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194605619",
            "telephone_number": "610-933-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "RAVDIN1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP041390L",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "RI26065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH STATE LICENSE NUMBER",
            "identifier": "RI26065",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH STATE LICENSE NUMBER",
            "identifier": "RP041390L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherise Small, LCSW
• Conchetta D Small
• Hubert Anton Small, MBBS
• Ronald J Small, DPM
• Shakina Small, MS, NCC, LPC, LBC
• Winona Alicia Small
• Rayna Smaller
• Brandon Smalls
• Lyrika Smalls
• Nahja Azee Smalls, CRNP

• Pharmacist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.