Charles Breitstadt, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

066652 Issued in NY

Practice address

6221 Ny-25a
Wading River, NY 11792

Phone

(631) 929-6040

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CVS Albany LLC

  dba CVS Pharmacy # 02726

  • Pharmacy
  • Wading River, NY
  • NPI 1710081567
  NPD (past)
• CVS Albany LLC

  dba CVS Pharmacy #11486

  • Pharmacy
  • Brooklyn, RI
  • NPI 1679459481
  NPD (past)

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1467040576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PINE NECK RD",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119713403",
            "telephone_number": "614-226-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 NY-25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "11792",
            "telephone_number": "631-929-6040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Manor Pl",
            "address_purpose": "LOCATION",
            "city": "Greenport",
            "state": "NY",
            "postal_code": "119441298",
            "country_code": "US",
            "telephone_number": "631-477-8877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREITSTADT",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "066652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Viktor Blatny, DPT
• Michelle Marie Bongiovanni
• Deborah Ann Bordonaro, PA
• Courtney Marie Braun, LMSW
• Diane Marie Brayer, RN
• Jon Neil Brodbeck, D.C.
• Tesia Marie Brooks, LMSW
• Myles Buhner, PHARMD
• Meredith Leslie Bushell, SPEECH PATHOLOGIST
• C Jay's Management Corporation

• Pharmacist in Wading River, NY
• Providers in Wading River, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.