Individual provider Active NPI

Jason T Zeno

  • Pharmacist
  • Glens Falls, NY
National Provider Identifier
1477733004
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047920 Issued in NY
Practice address
10 Broad St
Glens Falls, NY 12801-4327
Phone
(518) 792-1131
NPI assigned
Nov 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047920 NY Primary

Addresses

Primary practice location

10 Broad St
Glens Falls, NY 12801-4327

Mailing address

84 Perkins Dr
Hudson Falls, NY 12839-2646
Phone (518) 480-3350

Other identifiers 1

IdentifierTypeStateIssuer
047920MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1477733004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 PERKINS DR",
            "city": "HUDSON FALLS",
            "state": "NY",
            "postal_code": "128392646",
            "telephone_number": "518-480-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014327",
            "telephone_number": "518-792-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENO",
        "first_name": "JASON",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047920",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.