Active NPI
Jacqueline Rafael
- Pharmacist
- Great Neck, NY
National Provider Identifier
1518686187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067780
- Practice address
- 255 Community Drive, Suite 140
Great Neck, NY 11021 - Phone
- (833) 868-8486
- NPI assigned
- Aug 25, 2022
- 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 | 067780 | NY | Primary |
Addresses
Primary practice location
255 Community Drive, Suite 140
Great Neck, NY 11021
Mailing address
621 6TH Ave
New Hyde Park, NY 11040-5457
Phone (516) 424-8000
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 |
|---|---|---|---|
| 067780 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1518686187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 6TH AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110405457",
"telephone_number": "516-424-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 COMMUNITY DRIVE, SUITE 140",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11021",
"telephone_number": "833-868-8486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFAEL",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.