Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

017190 Issued in NY

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

800 Montauk Hwy
Shirley, NY 11967-2128

Phone

(631) 399-5252

Fax

(631) 399-5320

NPI assigned

Sep 20, 2006

Last updated

Oct 8, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC & PACIFIC TEA CO INCAs reported in NPPES

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

Authorized official

Name

Susan D Kijowski

Title

Regulatory Compliance Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Patrick Furey, R.PH.

  • Pharmacist
  • Shirley, NY
  • NPI 1053599266
  NPD (past)
• Ira Hauer

  • Pharmacist
  • Shirley, NY
  • NPI 1003084963
  NPD (past)
• Jasmine Thomas, PHARMD

  • Pharmacist
  • Shirley, NY
  • NPI 1285011015
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1316044183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700",
            "fax_number": "201-571-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672128",
            "telephone_number": "631-399-5252",
            "fax_number": "631-399-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO INC",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "REGULATORY COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "034086",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "017190",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3371933",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612166",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dominic Amechi Osemeka, B.PHARM
• Gargi Padki, RN
• Nicole Lyn Pallateri, RN
• Palmblad & Smit Dental, PLLC (Smile Makers)
• Pamela a Weber MD PC
• Amandy Patino
• Eileen Marie Pedreira
• Shannon Naomi Pendergast, LPN
• Annamaria Pepitone, FNP-C
• Bianca Pereira, OTD, OTR/L, CTRS

• Pharmacy in Shirley, NY
• Providers in Shirley, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.