Active NPI
Robert Michael Devivo
- Pharmacist
- Valley Stream, NY
National Provider Identifier
1396036497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 043203
- Practice address
- 531 W Merrick Rd
Valley Stream, NY 11580-5125 - Phone
- (516) 561-1222
- Fax
- (516) 561-1223
- NPI assigned
- Apr 22, 2011
- 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 | 043203 | NY | Primary |
Addresses
Primary practice location
531 W Merrick Rd
Valley Stream, NY 11580-5125
Mailing address
531 W Merrick Rd
Valley Stream, NY 11580-5125
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dedale Pharmacy Inc | Current | Accepting new patients |
Locations
531 W Merrick Rd
Valley Stream, NY 11580
Phone (516) 561-1222
Organizations & group practices 1
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": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1396036497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "531 W MERRICK RD",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115805125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 W MERRICK RD",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115805125",
"telephone_number": "516-561-1222",
"fax_number": "516-561-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVIVO",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-22",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "043203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.