Kidwell Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

31103 Issued in NY

Legal business name

KIDWELL INC

Doing business as

the pharmacy

Practice address

1770 Motor Parkway
Hauppauge, NY 11749

Phone

(631) 582-5959

Fax

(631) 582-6043

NPI assigned

Aug 15, 2006

Last updated

Oct 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Wistreich, RPH

Title

Supervising Pharmacist

Phone

(631) 582-5959

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• the pharmacy Doing business as

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1275546426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 MOTOR PKWY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117495260",
            "telephone_number": "631-582-5959",
            "fax_number": "631-582-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 MOTOR PARKWAY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11749",
            "telephone_number": "631-582-5959",
            "fax_number": "631-582-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWELL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "WISTREICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "631-582-5959",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "31103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "021254",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "the pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Kennedy
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• Sumaya Khanfri
• Roger Karl Khouri Jr., MD
• Samiha Kibria
• Jennifer Kies, M.S.E.D
• King Kullen Pharmacy
• Janine Kinkaid
• Jennifer Kirby, LMHC
• David Kitograd, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.