Individual provider Active NPI

John Vincent Pelella, R.PH.

  • Pharmacist
  • Cornwall, NY
National Provider Identifier
1518280908
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
029294 Issued in NY
Practice address
290 Main St
Cornwall, NY 12518-1579
Phone
(845) 534-4345
Fax
(845) 534-4048
NPI assigned
Mar 12, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 029294 NY Primary

Addresses

Primary practice location

290 Main St
Cornwall, NY 12518-1579

Mailing address

290 Main St
Cornwall, NY 12518-1579
Phone (845) 534-4345

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
029294NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelella Apothecary Inc Current Accepting new patients

Locations

290 Main St
Cornwall, NY 12518
Phone (845) 534-4345

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1518280908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MAIN ST",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181579",
            "telephone_number": "845-534-4345",
            "fax_number": "845-534-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MAIN ST",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181579",
            "telephone_number": "845-534-4345",
            "fax_number": "845-534-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELELLA",
        "first_name": "JOHN",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "029294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornwall, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.