Individual provider Active NPI

Jennifer Joseph Khabbaz, PHARMD

  • Pharmacist
  • Albany, NY
National Provider Identifier
1225661259
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
062511 Issued in NY
Practice address
1475 Western Ave
Albany, NY 12203-3520
Phone
(518) 482-8759
NPI assigned
Feb 18, 2020
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 062511 NY Primary

Addresses

Primary practice location

1475 Western Ave
Albany, NY 12203-3520

Mailing address

76 Major Ave
Staten Island, NY 10305-3733

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
062511NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1225661259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 MAJOR AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033520",
            "telephone_number": "518-482-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHABBAZ",
        "first_name": "JENNIFER",
        "middle_name": "JOSEPH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "062511",
            "primary": true
        }
    ],
    "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 Feb 18, 2020; 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.