Individual provider Active NPI

Edward F Sergott, RPH

  • Pharmacist
  • New Hartford, NY
National Provider Identifier
1386767705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
034266 Issued in NY
Practice address
4645 Commericial Drive
New Hartford, NY 14701
Phone
(716) 488-0640
Fax
(716) 483-6590
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 034266 NY Primary

Addresses

Primary practice location

4645 Commericial Drive
New Hartford, NY 14701

Mailing address

4645 Commericail Drive
New Hartford, NY 14701
Phone (716) 488-0640

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
034266NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386767705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 COMMERICAIL DRIVE",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-488-0640",
            "fax_number": "716-483-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 COMMERICIAL DRIVE",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-488-0640",
            "fax_number": "716-483-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGOTT",
        "first_name": "EDWARD",
        "middle_name": "F",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "034266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.