Active NPI
Angelique Rose Harris, PHARM.D.
- Pharmacist
- Clifton Park, NY
National Provider Identifier
1205556487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 069465
- Practice address
- 15 Park Ave
Clifton Park, NY 12065-2927 - Phone
- (518) 383-6780
- Fax
- (866) 301-3492
- NPI assigned
- Aug 30, 2022
- 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 | 069465 | NY | Primary |
Addresses
Primary practice location
15 Park Ave
Clifton Park, NY 12065-2927
Mailing address
4 Barnum LN
Mechanicville, NY 12118-3734
Phone (518) 502-3795
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 |
|---|---|---|---|
| 069465 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1205556487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 BARNUM LN",
"city": "MECHANICVILLE",
"state": "NY",
"postal_code": "121183734",
"telephone_number": "518-502-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PARK AVE",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120652927",
"telephone_number": "518-383-6780",
"fax_number": "866-301-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ANGELIQUE",
"middle_name": "ROSE",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-30",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "069465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.