Active NPI
Monica Mazur, RPH
- Pharmacist
- Boonville, NY
National Provider Identifier
1295919769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36414
- Practice address
- 102 E Schuyler St
Boonville, NY 13309-1104 - Phone
- (315) 942-4476
- NPI assigned
- Dec 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36414 | NY | Primary |
Addresses
Primary practice location
102 E Schuyler St
Boonville, NY 13309-1104
Mailing address
2153 Kotary Rd
Constableville, NY 13325-1915
Phone (315) 397-2503
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01016164 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36414 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1295919769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2153 KOTARY RD",
"city": "CONSTABLEVILLE",
"state": "NY",
"postal_code": "133251915",
"telephone_number": "315-397-2503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 E SCHUYLER ST",
"city": "BOONVILLE",
"state": "NY",
"postal_code": "133091104",
"telephone_number": "315-942-4476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZUR",
"first_name": "MONICA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "36414",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01016164",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boonville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.