Active NPI
Marco D Mennucci, RPH
- Pharmacist
- Geneseo, NY
National Provider Identifier
1407030414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049717
- Practice address
- 4287 Genesee Valley PLZ
Geneseo, NY 14454-9434 - Phone
- (585) 243-9020
- NPI assigned
- Dec 27, 2007
- Last updated
- Dec 27, 2007
- 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 | 049717 | NY | Primary |
Addresses
Primary practice location
4287 Genesee Valley PLZ
Geneseo, NY 14454-9434
Mailing address
4456 Federal Road
Livonia, NY 14487
Phone (585) 442-2118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049717 | Other | NY | PHARMACIST LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 049717 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1407030414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4456 FEDERAL ROAD",
"city": "LIVONIA",
"state": "NY",
"postal_code": "14487",
"telephone_number": "585-442-2118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4287 GENESEE VALLEY PLZ",
"city": "GENESEO",
"state": "NY",
"postal_code": "144549434",
"telephone_number": "585-243-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNUCCI",
"first_name": "MARCO",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-27",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "049717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "049717",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneseo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.