Mindy Kate Sussdorff, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

046183 Issued in NY

Practice address

25 Consumer Sqare
Walmart
Plattsburgh, NY 12901

Phone

(518) 561-0685

Fax

(518) 563-3675

NPI assigned

Mar 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1235452004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LEONARD AVE",
            "address_2": "APT. A",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012511",
            "telephone_number": "518-561-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CONSUMER SQARE",
            "address_2": "WALMART",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-561-0685",
            "fax_number": "518-563-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSDORFF",
        "first_name": "MINDY",
        "middle_name": "KATE",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "046183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.