Individual provider Active NPI

Kelly Ann Damiani, PHARMD

  • Pharmacist
  • Great Neck, NY
National Provider Identifier
1104174630
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20057104 Issued in NY
Practice address
50 Great Neck Rd
Great Neck, NY 11021-3305
Phone
(516) 466-3050
Fax
(516) 466-4804
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20057104 NY Primary

Addresses

Primary practice location

50 Great Neck Rd
Great Neck, NY 11021-3305

Mailing address

50 Great Neck Rd
Great Neck, NY 11021-3305
Phone (516) 466-3050

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20057104NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1104174630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GREAT NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213305",
            "telephone_number": "516-466-3050",
            "fax_number": "516-466-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GREAT NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213305",
            "telephone_number": "516-466-3050",
            "fax_number": "516-466-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIANI",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20057104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.