Individual provider Active NPI

Lauren Radziewicz

  • Pharmacist
  • Brentwood, NY
National Provider Identifier
1306626049
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
070707 Issued in NY
Practice address
1825 Brentwood Rd
Brentwood, NY 11717-4666
Phone
(631) 952-7752
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 070707 NY Primary

Addresses

Primary practice location

1825 Brentwood Rd
Brentwood, NY 11717-4666

Mailing address

66 Oneill Ave
Bay Shore, NY 11706-6827
Phone (631) 901-7977

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

State licenses

LicenseStateTypeSpecialty
070707NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1306626049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 ONEILL AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066827",
            "telephone_number": "631-901-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 BRENTWOOD RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174666",
            "telephone_number": "631-952-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZIEWICZ",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "070707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.