Active NPI
William Frank Petersen, R.PH.
- Pharmacist
- East Northport, NY
National Provider Identifier
1124207808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28113
- Practice address
- 8 Magenta LN
East Northport, NY 11731-5116 - Phone
- (631) 368-5412
- NPI assigned
- Oct 30, 2007
- 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 | 28113 | NY | Primary |
Addresses
Primary practice location
8 Magenta LN
East Northport, NY 11731-5116
Mailing address
8 Magenta LN
East Northport, NY 11731-5116
Phone (631) 368-5412
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 |
|---|---|---|---|
| 28113 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1124207808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 MAGENTA LN",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117315116",
"telephone_number": "631-368-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 MAGENTA LN",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117315116",
"telephone_number": "631-368-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "WILLIAM",
"middle_name": "FRANK",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-30",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "28113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.