Active NPI
Amanda Marie Vanic
- Pharmacist
- New York, NY
National Provider Identifier
1225487275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 062103
- Practice address
- 320 E 94TH St
New York, NY 10128-5604 - Phone
- (212) 241-6500
- NPI assigned
- Jun 10, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453118 | PA | |
| Pharmacist | 183500000X | 28RI03965000 | NJ | |
| Pharmacist | 183500000X | 062103 | NY | Primary |
Addresses
Primary practice location
320 E 94TH St
New York, NY 10128-5604
Mailing address
320 E 94TH St
New York, NY 10128-5604
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03965000 | NJ | MD | Pharmacist |
| 062103 | NY | MD | Pharmacist |
| RP453118 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients |
Organizations & group practices 1
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": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1225487275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E 94TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101285604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E 94TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101285604",
"telephone_number": "212-241-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANIC",
"first_name": "AMANDA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP453118",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03965000",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "062103",
"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 May 12, 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.