Active NPI
Charlie Katehis
- Pharmacist
- New York, NY
National Provider Identifier
1114594454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067604
- Practice address
- 1440 Broadway
New York, NY 10018-2301 - Phone
- (212) 221-3844
- NPI assigned
- Jun 7, 2021
- Last updated
- Jun 7, 2021
- 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 | 067604 | NY | Primary |
Addresses
Primary practice location
1440 Broadway
New York, NY 10018-2301
Mailing address
290 9TH Ave Apt 6B
New York, NY 10001-5726
Phone (917) 204-4608
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 |
|---|---|---|---|
| 067604 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1114594454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 9TH AVE APT 6B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100015726",
"telephone_number": "917-204-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100182301",
"telephone_number": "212-221-3844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATEHIS",
"first_name": "CHARLIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-07",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.