Individual provider Active NPI

Vincent Pham, PHARMD

  • Pharmacist
  • Albany, NY
National Provider Identifier
1205683414
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
069508 Issued in NY
Practice address
25 Walker Way Ste 3D
Albany, NY 12205-4963
Phone
(518) 464-0871
NPI assigned
May 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 069508 NY Primary
Nuclear Pharmacist 1835N0905X 069508 NY

Addresses

Primary practice location

25 Walker Way Ste 3D
Albany, NY 12205-4963

Mailing address

4140 Albany St
Albany, NY 12205-4436
Phone (518) 550-8172

Other practice location 1

14 Walker Way Ste 5
Albany, NY 12205-4968
Phone (518) 713-2068

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

LicenseStateTypeSpecialty
069508NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1205683414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 ALBANY ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054436",
            "telephone_number": "518-550-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WALKER WAY STE 3D",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054963",
            "telephone_number": "518-464-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Walker Way Ste 5",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122054968",
            "country_code": "US",
            "telephone_number": "518-713-2068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VINCENT",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-04",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "069508",
            "primary": true
        },
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "NY",
            "license": "069508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.