Active NPI
Jeremy Daniel Benderoff, R.PH
- Pharmacist
- Yonkers, NY
National Provider Identifier
1326643529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065095
- Practice address
- 2290 Central Park Ave
Yonkers, NY 10710-1216 - Phone
- (914) 793-3933
- NPI assigned
- Dec 3, 2020
- Sex
- Male
- 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 | 065095 | NY | Primary |
Addresses
Primary practice location
2290 Central Park Ave
Yonkers, NY 10710-1216
Mailing address
21 Bennett Ave Apt 46
New York, NY 10033-3607
Phone (519) 494-5196
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 |
|---|---|---|---|
| 065095 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1326643529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 BENNETT AVE APT 46",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100333607",
"telephone_number": "519-494-5196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2290 CENTRAL PARK AVE",
"city": "YONKERS",
"state": "NY",
"postal_code": "107101216",
"telephone_number": "914-793-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDEROFF",
"first_name": "JEREMY",
"middle_name": "DANIEL",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.