Simona Bagdasarian, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

042254 Issued in NY

Practice address

6535 Woodhaven Blvd
Rego Park, NY 11374-5047

Phone

(718) 520-6744

NPI assigned

Nov 21, 2007

Last updated

Nov 21, 2007By the provider in NPPES

Sex

Female

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1316128093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 255TH ST",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622445",
            "telephone_number": "718-224-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745047",
            "telephone_number": "718-520-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGDASARIAN",
        "first_name": "SIMONA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Rego Park, NY
• Providers in Rego Park, 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 21, 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.

Verify at the official NPI Registry.