Active NPI
Jennifer E O'Connor, RPH
- Pharmacist
- Maspeth, NY
National Provider Identifier
1124278338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 47900
- Practice address
- 74-17 Grand Avenue
Maspeth, NY 11378 - Phone
- (718) 803-3025
- Fax
- (718) 803-3209
- NPI assigned
- Sep 24, 2008
- Sex
- Female
- 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 | 47900 | NY | Primary |
Addresses
Primary practice location
74-17 Grand Avenue
Maspeth, NY 11378
Mailing address
74 17 Grand Ave
Maspeth, NY 11378
Phone (718) 803-3025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02160676 | 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 |
|---|---|---|---|
| 47900 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stop and Shop Supermarket Co LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Kinnelon, NJ
- NPI 1932570363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222214400000",
"number": "1124278338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 17 GRAND AVE",
"city": "MASPETH",
"state": "NY",
"postal_code": "11378",
"telephone_number": "718-803-3025",
"fax_number": "718-803-3209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74-17 GRAND AVENUE",
"city": "MASPETH",
"state": "NY",
"postal_code": "11378",
"telephone_number": "718-803-3025",
"fax_number": "718-803-3209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "JENNIFER",
"middle_name": "E",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-24",
"last_updated": "2008-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "47900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02160676",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maspeth, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.