Active NPI
An Pham
- Pharmacist
- New York, NY
National Provider Identifier
1174275424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 066636
- Practice address
- 2182 Broadway
New York, NY 10024-6612 - Phone
- (212) 799-0102
- NPI assigned
- Jan 18, 2022
- 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 | 066636 | NY | Primary |
Addresses
Primary practice location
2182 Broadway
New York, NY 10024-6612
Mailing address
2182 Broadway
New York, NY 10024-6612
Phone (212) 799-0102
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1174275424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2182 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246612",
"telephone_number": "212-799-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2182 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246612",
"telephone_number": "212-799-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "AN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-18",
"last_updated": "2022-01-18",
"certification_date": "2022-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "066636",
"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 Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.