Active NPI
Paula Vanessa Rodrigues
- Pharmacist
- Jericho, NY
National Provider Identifier
1467622548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042096
- Practice address
- 417 N Broadway
Jericho, NY 11753-2106 - Phone
- (516) 938-9400
- Fax
- (516) 433-3409
- NPI assigned
- Mar 5, 2008
- Sex
- Female
- 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 | 042096 | NY | Primary |
Addresses
Primary practice location
417 N Broadway
Jericho, NY 11753-2106
Mailing address
417 North Broaway
Jericho, NY 11753
Phone (516) 938-9400
Other names 1
- Mr. Paula Vanessa Martins
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 |
|---|---|---|---|
| 042096 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | 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": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1467622548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 NORTH BROAWAY",
"city": "JERICHO",
"state": "NY",
"postal_code": "11753",
"telephone_number": "516-938-9400",
"fax_number": "516-433-3409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 N BROADWAY",
"city": "JERICHO",
"state": "NY",
"postal_code": "117532106",
"telephone_number": "516-938-9400",
"fax_number": "516-433-3409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUES",
"first_name": "PAULA",
"middle_name": "VANESSA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PAULA",
"last_name": "MARTINS",
"middle_name": "VANESSA",
"prefix": "MR.",
"credential": "RPH",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Jericho, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.