Individual provider Active NPI

Mark Patrick Freitas, R.PH.

  • Pharmacist
  • Washingtonville, NY
National Provider Identifier
1558490235
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
039972 Issued in NY
Practice address
32 W Main St Unit 2
Washingtonville, NY 10992-1411
Phone
(845) 496-8001
Fax
(845) 496-8005
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X R26118 NJ
Pharmacist 183500000X RP041340R PA
Pharmacist 183500000X 039972 NY Primary

Addresses

Primary practice location

32 W Main St Unit 2
Washingtonville, NY 10992-1411

Mailing address

32 W Main St Unit 2
Washingtonville, NY 10992-1411
Phone (845) 496-8001

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
R26118NJMDPharmacist
039972NYMDPharmacist
RP041340RPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Washingtonville Pharmacy Inc CurrentSince Sep 4, 2022 Accepting new patients
Washingtonville Pharmacy Inc CurrentSince Oct 16, 2022 Accepting new patients

Locations

6 Depot St
Ste 105
Washingtonville, NY 10992
Phone (845) 496-8001

32 W Main St
Ste 2
Washingtonvle, NY 10992
Phone (845) 496-8001

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1558490235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 W MAIN ST UNIT 2",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109921411",
            "telephone_number": "845-496-8001",
            "fax_number": "845-496-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 W MAIN ST UNIT 2",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109921411",
            "telephone_number": "845-496-8001",
            "fax_number": "845-496-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREITAS",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "R26118",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP041340R",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "039972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washingtonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.