NPIMap

Organization Active NPI

66 Nagle Avenue Corp

Doing business as Theresa Pharmacy II

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1427031475
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
022529 Issued in NY
Legal business name
66 NAGLE AVENUE CORP
Doing business as
Theresa Pharmacy II
Practice address
66 Nagle Ave
New York, NY 10040-1406
Phone
(212) 304-3949
Fax
(212) 304-4339
NPI assigned
Nov 23, 2005
Last updated
Apr 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Authorized official

Name
Robert NewmanNPI 1578895991
Title
Pharmacist/VP
Phone
(212) 304-3949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 022529 NY Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

66 Nagle Ave
New York, NY 10040-1406

Mailing address

66 Nagle Ave
New York, NY 10040-1406
Phone (212) 304-3949

Other identifiers 2

IdentifierTypeStateIssuer
01584358MedicaidNY
3302712OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • THERESA PHARMACY II Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1427031475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401406",
            "telephone_number": "212-304-3949",
            "fax_number": "212-304-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401406",
            "telephone_number": "212-304-3949",
            "fax_number": "212-304-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "66 NAGLE AVENUE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST/VP",
        "authorized_official_telephone_number": "212-304-3949"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "022529",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01584358",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3302712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THERESA PHARMACY II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.

Verify at the official NPI Registry.