Active NPI
Debra Chin, R.PH.
- Pharmacist
- Monticello, NY
National Provider Identifier
1124204144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 31199
- Practice address
- 381 Broadway Street
Monticello, NY 12701-1385 - Phone
- (845) 791-1130
- Fax
- (845) 791-1316
- NPI assigned
- Jan 22, 2008
- Last updated
- Jan 22, 2008
- Sex
- Female
- 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 | 31199 | NY | Primary |
Addresses
Primary practice location
381 Broadway Street
Monticello, NY 12701-1385
Mailing address
381 Broadway
Monticello, NY 12701-1385
Phone (845) 791-1130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01789968 | Medicaid | NY |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31199 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1124204144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "381 BROADWAY",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127011385",
"telephone_number": "845-791-1130",
"fax_number": "845-791-1316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 BROADWAY STREET",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127011385",
"telephone_number": "845-791-1130",
"fax_number": "845-791-1316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "DEBRA",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "31199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01789968",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.