Active NPI
Michael Rudner, P.H.
- Pharmacist
- Far Rockaway, NY
National Provider Identifier
1093038572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 27752
- Practice address
- 2102 Mott Ave
Far Rockaway, NY 11691-3302 - Phone
- (718) 327-2559
- NPI assigned
- Mar 11, 2010
- Last updated
- Mar 11, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 27752 | NY | Primary |
Addresses
Primary practice location
2102 Mott Ave
Far Rockaway, NY 11691-3302
Mailing address
906 Cliffside Ave
Valley Stream, NY 11581-3048
Phone (516) 791-6650
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27752 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriftway Far Rockaway Drug Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Thriftway Pharmacy
- Community/Retail Pharmacy
- Far Rockaway, NY
- NPI 1265537807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268265600000",
"number": "1093038572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 CLIFFSIDE AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115813048",
"telephone_number": "516-791-6650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 MOTT AVE",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116913302",
"telephone_number": "718-327-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDNER",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "P.H.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-11",
"last_updated": "2010-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "27752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Far Rockaway, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.