Individual provider Active NPI

Rodger Rosicki, RPH

  • Pharmacist
  • South Setauket, NY
National Provider Identifier
1336462217
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036803 Issued in NY
Practice address
260 Pond Path
South Setauket, NY 11720-2006
Phone
(631) 585-4469
Fax
(631) 585-4331
NPI assigned
Mar 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 036803 NY Primary

Addresses

Primary practice location

260 Pond Path
South Setauket, NY 11720-2006

Mailing address

260 Pond Path
South Setauket, NY 11720-2006
Phone (631) 585-4469

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

LicenseStateTypeSpecialty
036803NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1336462217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 POND PATH",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117202006",
            "telephone_number": "631-585-4469",
            "fax_number": "631-585-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 POND PATH",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117202006",
            "telephone_number": "631-585-4469",
            "fax_number": "631-585-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSICKI",
        "first_name": "RODGER",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.