Individual provider Active NPI

Jean Marie Runco

  • Pharmacist
  • Briarcliff Manor, NY
National Provider Identifier
1356065452
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
069704 Issued in NY
Practice address
89 N State Rd
Briarcliff Manor, NY 10510-1415
Phone
(914) 941-1970
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 069704 NY Primary

Addresses

Primary practice location

89 N State Rd
Briarcliff Manor, NY 10510-1415

Mailing address

158 Edgewood Ave
Yonkers, NY 10704-2358

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
069704NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oprx Pharmacy #10510, LLC CurrentSince Apr 13, 2025 Accepting new patients
Value Drugs 9 Inc. PastSince Apr 13, 2025 Accepting new patients
GSP Longterm Care Inc PastSince Oct 1, 2022 Accepting new patients

Locations

89 N State Rd
Briarcliff Manor, NY 10510
Phone (914) 941-1970

Organizations & group practices 3

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1356065452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 EDGEWOOD AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107042358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 N STATE RD",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105101415",
            "telephone_number": "914-941-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNCO",
        "first_name": "JEAN MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "069704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarcliff Manor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.