Individual provider Active NPI

Mark Bradley Ackerman, RPH

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1265680649
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27822 Issued in NY
Practice address
255 E Gun Hill Rd
Bronx, NY 10467-2109
Phone
(718) 654-1685
NPI assigned
Aug 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27822 NY Primary

Addresses

Primary practice location

255 E Gun Hill Rd
Bronx, NY 10467-2109

Mailing address

255 E Gun Hill Rd
Bronx, NY 10467-2109
Phone (718) 654-1685

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
27822NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KMN Pharmacy Corp Past Accepting new patients
KMN Pharmacy Corp PastSince Jan 28, 2024 Accepting new patients

Organizations & group practices 2

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1265680649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672109",
            "telephone_number": "718-654-1685",
            "fax_number": "718-515-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672109",
            "telephone_number": "718-654-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "MARK",
        "middle_name": "BRADLEY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "27822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.