Active NPI
William S Dudek, RPH
- Pharmacist
- Albany, NY
National Provider Identifier
1083781637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28217
- Practice address
- 113 Holland Ave
Albany, NY 12208-3410 - Phone
- (518) 626-5000
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28217 | NY | Primary |
Addresses
Primary practice location
113 Holland Ave
Albany, NY 12208-3410
Mailing address
1 Mates Way
Waterford, NY 12188-1165
Phone (518) 383-0334
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28217 | Other | NY | LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28217 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083781637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MATES WAY",
"city": "WATERFORD",
"state": "NY",
"postal_code": "121881165",
"telephone_number": "518-383-0334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 HOLLAND AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083410",
"telephone_number": "518-626-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDEK",
"first_name": "WILLIAM",
"middle_name": "S",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "28217",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "28217",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.