Active NPI
Nagi Wissa
- Pharmacist
- Mahopac, NY
National Provider Identifier
1407026024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049260
- Practice address
- 559 Route 6
Lake Mahopca Pharamcy & Surgical
Mahopac, NY 10541 - Phone
- (845) 208-0424
- Fax
- (845) 208-0425
- NPI assigned
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 049260 | NY | Primary |
Addresses
Primary practice location
559 Route 6
Lake Mahopca Pharamcy & Surgical
Mahopac, NY 10541
Mailing address
559 Route 6
Lake Mahopac Pharmacy & Surgical
Mahopac, NY 10541
Phone (845) 208-0424
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 |
|---|---|---|---|
| 049260 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nacsip Inc | Current | Accepting new patients |
Locations
559 Route 6
Mahopac, NY 10541
Phone (845) 208-0424
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.
-
- Pharmacy
- Mahopac, NY
- NPI 1396073060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1407026024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 ROUTE 6",
"address_2": "LAKE MAHOPAC PHARMACY & SURGICAL",
"city": "MAHOPAC",
"state": "NY",
"postal_code": "10541",
"telephone_number": "845-208-0424",
"fax_number": "845-208-0425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 ROUTE 6",
"address_2": "LAKE MAHOPCA PHARAMCY & SURGICAL",
"city": "MAHOPAC",
"state": "NY",
"postal_code": "10541",
"telephone_number": "845-208-0424",
"fax_number": "845-208-0425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISSA",
"first_name": "NAGI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "049260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mahopac, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.