Active NPI
Desiree Croteau, PHARMD, BCOP
- Oncology Pharmacist
- Philadelphia, PA
National Provider Identifier
1194579771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Pharmacist
- License
- RP446090
- Practice address
- 3400 Civic Center Blvd
Philadelphia, PA 19104-5127 - Phone
- (267) 624-4643
- NPI assigned
- Apr 11, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | 062943 | NY | |
| Oncology Pharmacist | 1835X0200X | RP446090 | PA | Primary |
Addresses
Primary practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Mailing address
3400 Spruce St
Gates - 2ND Floor Pharmacy Administration
Philadelphia, PA 19104
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 062943 | NY | MD | Oncology Pharmacist |
| RP446090 | PA | MD | Oncology Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1194579771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "GATES - 2ND FLOOR PHARMACY ADMINISTRATION",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "267-624-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROTEAU",
"first_name": "DESIREE",
"credential": "PHARMD, BCOP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-11",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "NY",
"license": "062943",
"primary": false
},
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "PA",
"license": "RP446090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.