Waldbaum Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

023688 Issued in NY

Legal business name

WALDBAUM INC

Doing business as

Waldbaums Pharmacy

Practice address

4054 Nesconset Hwy
Setauket, NY 11733-3306

Phone

(631) 476-1586

Fax

(631) 476-0201

NPI assigned

Jul 13, 2006

Last updated

Nov 15, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INCAs reported in NPPES

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

Authorized official

Name

Susan Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• WALDBAUMS PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Anne Isler, RPH

  • Pharmacist
  • East Setauket, NY
  • NPI 1770751620
  NPD (past)
• Cathy Pagliara, R.PH.

  • Pharmacist
  • Setauket, NY
  • NPI 1083892251
  NPD (past)
• Melissa Papandrea, PHARMD

  • Pharmacist
  • Setauket, NY
  • NPI 1770724049
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1558386102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 NESCONSET HWY",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117333306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 NESCONSET HWY",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117333306",
            "telephone_number": "631-476-1586",
            "fax_number": "631-476-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDBAUM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "023688",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "023688",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "018669710442",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01866971",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3342297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDBAUMS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andre Vilardi, RN
• Virtual Medicine Wellness
• Virtual Medicine Wellness
• Lisa Volpe-Smith, M.A.
• Frederick William Wagner III, MED
• Caroline Walsh
• Claudine Weiner, ATC
• Alexa Weissman
• Andrea Weissman, MACCC-SLP
• Nancy Weitzman, PHD

• Pharmacy in Setauket, NY
• Providers in Setauket, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.