Active NPI
Michael James Cannella
- Pharmacist
- New York, NY
National Provider Identifier
1376032037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 063141
- Practice address
- 300 W 135TH St
New York, NY 10030-2731 - Phone
- (212) 491-6015
- NPI assigned
- May 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 063141 | NY | Primary |
Addresses
Primary practice location
300 W 135TH St
New York, NY 10030-2731
Mailing address
4559 195TH St
Flushing, NY 11358-3525
Phone (917) 572-6930
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 |
|---|---|---|---|
| 063141 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1376032037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4559 195TH ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113583525",
"telephone_number": "917-572-6930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 135TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100302731",
"telephone_number": "212-491-6015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNELLA",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-08",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "063141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.