Individual provider Active NPI

Michael Angelo Valladares, PHARMD, RPH

  • Pharmacist
  • Astoria, NY
National Provider Identifier
1407367659
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063480 Issued in NY
Practice address
2620 Hoyt Ave S
Astoria, NY 11102-2870
Phone
(347) 507-1680
Fax
(347) 507-1651
NPI assigned
Oct 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063480 NY Primary

Addresses

Primary practice location

2620 Hoyt Ave S
Astoria, NY 11102-2870

Mailing address

18 Tiffany PL Apt 2L
Brooklyn, NY 11231-2893
Phone (617) 981-2418

Other practice location 1

3908A White Plains Rd
Bronx, NY 10466-3018
Phone (718) 676-5959

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
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
063480NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Care First Pharmacy Corp Past Accepting new patients

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407367659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TIFFANY PL APT 2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312893",
            "telephone_number": "617-981-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 HOYT AVE S",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022870",
            "telephone_number": "347-507-1680",
            "fax_number": "347-507-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3908A White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104663018",
            "country_code": "US",
            "telephone_number": "718-676-5959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLADARES",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.