Cloyd John Dean
Individual provider Active NPI Pharmacist · Cuba, NY
NPI 1487835898 · NPPES record last updated Nov 14, 2007
Key facts
- NPI
- 1487835898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 029141 (NY)
- Practice address
- 10 W Main St
Cuba, NY 14727-1404 - Phone
- (585) 968-1410
- NPI assigned
- Nov 14, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 029141 | NY | Yes |
Addresses
Primary practice location
10 W Main St
Cuba, NY 14727-1404
Mailing address
239 W Shore Rd
Cuba, NY 14727-9626
Phone (585) 968-1591
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01068455 | Medicaid | NY |
Other providers in Cuba, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.