Marybeth Walker
Individual provider Active NPI Pharmacist · New Winsor, NY
NPI 1104019041 · NPPES record last updated Aug 23, 2007
Key facts
- NPI
- 1104019041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 033652 (NY)
- Practice address
- 2636 Route 32
New Winsor, NY 12553 - Phone
- (845) 562-5292
- NPI assigned
- Aug 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033652 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin'S Foods of South Burlington, LLC | Past | Accepting new patients | |
| Martins Foods of South Burlington LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033652 | NY | Yes |
Addresses
Primary practice location
2636 Route 32
New Winsor, NY 12553
Mailing address
PO Box 1000
Ms3000
Portland, ME 04104-5005
Phone (207) 885-7454
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.