Active NPI
Crystal McDonald
- Pharmacist
- Commack, NY
National Provider Identifier
1497022925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 056178
- Practice address
- 44 Timber Ridge Dr
Commack, NY 11725-1742 - Phone
- (631) 455-7112
- NPI assigned
- Nov 29, 2011
- 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 | 056178 | NY | Primary |
Addresses
Primary practice location
44 Timber Ridge Dr
Commack, NY 11725-1742
Mailing address
44 Timber Ridge Dr
Commack, NY 11725-1742
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497022925 | Medicaid | NY |
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 |
|---|---|---|---|
| 056178 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1497022925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 TIMBER RIDGE DR",
"city": "COMMACK",
"state": "NY",
"postal_code": "117251742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 TIMBER RIDGE DR",
"city": "COMMACK",
"state": "NY",
"postal_code": "117251742",
"telephone_number": "631-455-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-29",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497022925",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commack, NY
- Susan Christine McCormack, M.A., CCC-SLP
- Kerry A McCormick, PTA
- Alyssa McCoun, MS CCC-SLP TSSLD
- Maria Regina McCutcheon, PTA
- Kathy Ann McDermott, RNMSNPP
- Jennifer McDonald, MS, SPECIAL ED
- Nancy A. McGee, M.A., CCC-A
- Christine McGill, M.D.
- Kelly Eileen McGowan, FNP
- Margaret Anne McGuire, M.S SPECIAL ED
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.