Active NPI
Isaac David Mall
- Pharmacist
- Albany, NY
National Provider Identifier
1437703907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065596
- Practice address
- 26 Picotte Dr
Albany, NY 12208-1710 - Phone
- (518) 435-2315
- NPI assigned
- Aug 1, 2019
- 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 | 065596 | NY | Primary |
Addresses
Primary practice location
26 Picotte Dr
Albany, NY 12208-1710
Mailing address
92 Huron St.
Albany, NY 12203
Phone (518) 588-2781
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 |
|---|---|---|---|
| 065596 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crestwood Health Inc | Pharmacist | Past | Accepting new patients |
| Crestwood Health Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Crestwood Pharmacy
- Community/Retail Pharmacy
- Albany, NY
- NPI 1295836898
Pharmacist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1437703907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 HURON ST.",
"city": "ALBANY",
"state": "NY",
"postal_code": "12203",
"telephone_number": "518-588-2781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 PICOTTE DR",
"city": "ALBANY",
"state": "NY",
"postal_code": "122081710",
"telephone_number": "518-435-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALL",
"first_name": "ISAAC",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.