Individual provider Active NPI

Ronald E Reudink, RPH

  • Pharmacist
  • Syracuse, NY
National Provider Identifier
1366624850
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
026864-1 Issued in NY
Practice address
63 Heritage Cir
Syracuse, NY 13209-1707
Phone
(315) 488-0054
NPI assigned
Nov 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 026864-1 NY Primary

Addresses

Primary practice location

63 Heritage Cir
Syracuse, NY 13209-1707

Mailing address

63 Heritage Cir
Syracuse, NY 13209-1707
Phone (315) 488-0054

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
026864-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1366624850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 HERITAGE CIR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091707",
            "telephone_number": "315-488-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 HERITAGE CIR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132091707",
            "telephone_number": "315-488-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REUDINK",
        "first_name": "RONALD",
        "middle_name": "E",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "026864-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.