Active NPI
Agnieszka Bak
- Pharmacist
- Syracuse, NY
National Provider Identifier
1487053161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 059643
- Practice address
- 4713 Onondaga Blvd
Syracuse, NY 13219-3371 - Phone
- (315) 403-5112
- NPI assigned
- Aug 18, 2014
- 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 | 059643 | NY | Primary |
Addresses
Primary practice location
4713 Onondaga Blvd
Syracuse, NY 13219-3371
Mailing address
4712 Onondaga Blvd
Syracuse, NY 13219-1605
Phone (315) 472-3832
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 |
|---|---|---|---|
| 059643 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449619200000",
"number": "1487053161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4712 ONONDAGA BLVD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132191605",
"telephone_number": "315-472-3832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4713 ONONDAGA BLVD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193371",
"telephone_number": "315-403-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAK",
"first_name": "AGNIESZKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2015-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "059643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.