Individual provider Active NPI

Salvatore Anthony Marcello, PHARM. D.

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1114495652
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064925 Issued in NY
Practice address
955 Manor Rd
Staten Island, NY 10314-7009
Phone
(718) 983-7390
NPI assigned
Nov 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064925 NY Primary

Addresses

Primary practice location

955 Manor Rd
Staten Island, NY 10314-7009

Mailing address

955 Manor Rd
Staten Island, NY 10314-7009
Phone (718) 983-7390

Other identifiers 1

IdentifierTypeStateIssuer
064925OtherNYPHARMACY LICENSE

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
064925NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Sep 8, 2024 Accepting new patients
Walgreen Co PastSince Sep 8, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1114495652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MANOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147009",
            "telephone_number": "718-983-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MANOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147009",
            "telephone_number": "718-983-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLO",
        "first_name": "SALVATORE",
        "middle_name": "ANTHONY",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "064925",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.