NPIMap

Individual provider Active NPI

Peter T Burdash

  • Pharmacist
  • Modena, NY
National Provider Identifier
1346433802
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
045391 Issued in NY
Practice address
2066 RT 32
Modena, NY 12548
Phone
(845) 883-7469
Fax
(845) 883-7530
NPI assigned
Aug 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 045391 NY Primary

Addresses

Primary practice location

2066 RT 32
Modena, NY 12548

Mailing address

2066 RT 32
Modena, NY 12548
Phone (845) 883-7469

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

State licenses

LicenseStateTypeSpecialty
045391NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin'S Foods of South Burlington, LLC Past Accepting new patients
Martins Foods of South Burlington 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1346433802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 RT 32",
            "city": "MODENA",
            "state": "NY",
            "postal_code": "12548",
            "telephone_number": "845-883-7469",
            "fax_number": "845-883-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 RT 32",
            "city": "MODENA",
            "state": "NY",
            "postal_code": "12548",
            "telephone_number": "845-883-7469",
            "fax_number": "845-883-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDASH",
        "first_name": "PETER",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-19",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.