Individual provider Active NPI

Stephanie M Martin

  • Pharmacist
  • Howard Beach, NY
National Provider Identifier
1124350640
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042282-1 Issued in NY
Practice address
15705 Crossbay Blvd
Howard Beach, NY 11414-2748
Phone
(718) 848-4507
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 042282-1 NY Primary

Addresses

Primary practice location

15705 Crossbay Blvd
Howard Beach, NY 11414-2748

Mailing address

171 Beach 136TH St
Belle Harbor, NY 11694-1311
Phone (917) 691-4838

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

LicenseStateTypeSpecialty
042282-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1124350640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 BEACH 136TH ST",
            "city": "BELLE HARBOR",
            "state": "NY",
            "postal_code": "116941311",
            "telephone_number": "917-691-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15705 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142748",
            "telephone_number": "718-848-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042282-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.