Individual provider Active NPI

Scott Richard Grazda, RPH

  • Pharmacist
  • Clifton Park, NY
National Provider Identifier
1265611735
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
041584 Issued in NY
Practice address
80 Deer Run Holw
Clifton Park, NY 12065-5663
Phone
(518) 383-9439
NPI assigned
Oct 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 041584 NY Primary

Addresses

Primary practice location

80 Deer Run Holw
Clifton Park, NY 12065-5663

Mailing address

80 Deer Run Holw
Clifton Park, NY 12065-5663
Phone (518) 383-9439

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
041584NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1265611735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 DEER RUN HOLW",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655663",
            "telephone_number": "518-383-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 DEER RUN HOLW",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655663",
            "telephone_number": "518-383-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZDA",
        "first_name": "SCOTT",
        "middle_name": "RICHARD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "041584",
            "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 Oct 31, 2007; 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.