Active NPI
Jodi Clark
- Pharmacist
- Staten Island, NY
National Provider Identifier
1346562162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051946
- Practice address
- 260 Arden Ave
Staten Island, NY 10312-1229 - Phone
- (718) 966-5509
- Fax
- (718) 966-0044
- NPI assigned
- Feb 21, 2010
- Sex
- Female
- 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 | 051946 | NY | Primary |
Addresses
Primary practice location
260 Arden Ave
Staten Island, NY 10312-1229
Mailing address
729 Woodrow Rd
Staten Island, NY 10312-2221
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051946 | NY | MD | Pharmacist |
Interoperability endpoints
- jclark@direct.buffaloniagaragi.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266710400000",
"number": "1346562162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "729 WOODROW RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103122221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 ARDEN AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103121229",
"telephone_number": "718-966-5509",
"fax_number": "718-966-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JODI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-21",
"last_updated": "2010-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "051946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.