Individual provider Active NPI

Roberto Camisa, RPH.

  • Pharmacist
  • Elmhurst, NY
National Provider Identifier
1417288523
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047626 Issued in NY
Practice address
8615 Queens Blvd
Elmhurst, NY 11373-4427
Phone
(718) 446-2100
Fax
(718) 478-9298
NPI assigned
Jan 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047626 NY Primary

Addresses

Primary practice location

8615 Queens Blvd
Elmhurst, NY 11373-4427

Mailing address

8615 Queens Blvd
Elmhurst, NY 11373-4427

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

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1417288523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734427",
            "telephone_number": "718-446-2100",
            "fax_number": "718-478-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMISA",
        "first_name": "ROBERTO",
        "credential": "RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.