Individual provider Active NPI

David C Abdoo, RPH

  • Pharmacist
  • Monticello, NY
National Provider Identifier
1265990956
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064769 Issued in NY
Practice address
381 Broadway
Monticello, NY 12701
Phone
(845) 791-1301
NPI assigned
Mar 12, 2019
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064769 NY Primary

Addresses

Primary practice location

381 Broadway
Monticello, NY 12701

Mailing address

75 Davos PT
Woodridge, NY 12789-5907
Phone (518) 429-5527

Other practice location 1

1934 Route 52
Liberty, NY 12754-8310
Phone (845) 292-4114

Other practice location 2

1934 Route 52
Liberty, NY 12754-8310
Phone (845) 292-4114

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
064769NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1265990956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 DAVOS PT",
            "city": "WOODRIDGE",
            "state": "NY",
            "postal_code": "127895907",
            "telephone_number": "518-429-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 BROADWAY",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "12701",
            "telephone_number": "845-791-1301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1934 Route 52",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "NY",
            "postal_code": "127548310",
            "country_code": "US",
            "telephone_number": "845-292-4114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1934 Route 52",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "NY",
            "postal_code": "127548310",
            "country_code": "US",
            "telephone_number": "845-292-4114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDOO",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.