Active NPI
Evan Tyler Banbury, PHARMD
- Pharmacist
- Hyde Park, NY
National Provider Identifier
1336923358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 070566
- Practice address
- 4246 Albany Post Rd
Hyde Park, NY 12538-1700 - Phone
- (845) 229-2224
- NPI assigned
- Aug 21, 2023
- Last updated
- Aug 21, 2023
- 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 | 070566 | NY | Primary |
Addresses
Primary practice location
4246 Albany Post Rd
Hyde Park, NY 12538-1700
Mailing address
4246 Albany Post Rd
Hyde Park, NY 12538-1700
Other practice location 1
416 Washington Ave
Kingston, NY 12401-3704
Phone (845) 331-0226
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070566 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1336923358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4246 ALBANY POST RD",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "125381700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4246 ALBANY POST RD",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "125381700",
"telephone_number": "845-229-2224"
}
],
"practiceLocations": [
{
"address_1": "416 Washington Ave",
"address_purpose": "LOCATION",
"city": "Kingston",
"state": "NY",
"postal_code": "124013704",
"country_code": "US",
"telephone_number": "845-331-0226",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANBURY",
"first_name": "EVAN",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-21",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "070566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.