Individual provider Active NPI

Alan J Konner, R.PH.

  • Pharmacist
  • New Paltz, NY
National Provider Identifier
1487802104
Registry record updated Sep 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036116 Issued in NY
Practice address
26 New Paltz PLZ
New Paltz, NY 12561-1616
Phone
(845) 255-3344
Fax
(845) 255-8985
NPI assigned
Sep 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 036116 NY Primary

Addresses

Primary practice location

26 New Paltz PLZ
New Paltz, NY 12561-1616

Mailing address

26 New Paltz PLZ
New Paltz, NY 12561-1616
Phone (845) 255-3344

Other identifiers 1

IdentifierTypeStateIssuer
01309195MedicaidNY

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
036116NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220659200000",
    "number": "1487802104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 NEW PALTZ PLZ",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611616",
            "telephone_number": "845-255-3344",
            "fax_number": "845-255-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 NEW PALTZ PLZ",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611616",
            "telephone_number": "845-255-3344",
            "fax_number": "845-255-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONNER",
        "first_name": "ALAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-06",
        "last_updated": "2008-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309195",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.