Alquon Hailstock

Primary specialty

PharmacistTaxonomy code 183500000X

License

064977 Issued in NY

Practice address

215 Park Ave S
New York, NY 10003-1603

Phone

(646) 602-8237

NPI assigned

Nov 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1295338036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DECATUR ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031603",
            "telephone_number": "646-602-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILSTOCK",
        "first_name": "ALQUON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02053987",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rxconnect",
            "affiliation": "Y",
            "affiliationName": "CVS ALBANY LLC",
            "address_1": "215 Park Ave S",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100031603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zachary Haigney, L.AC.
• Hanna Haile, MD
• Marian Hailey-Moss, LCSW
• Christy Hailey
• Patricia Hailey
• Florence Hailstock
• Mekdes Hailu
• Tsega Hailu, MD
• Lior Haim, M.D.
• Nadav Haim, M.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.