Active NPI
Jerry Silva, RPH
- Pharmacist
- Long Beach, NY
National Provider Identifier
1568680155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 021246
- Practice address
- 750 Park PL
Long Beach, NY 11561-2110 - Phone
- (516) 536-0800
- Fax
- (516) 889-8690
- NPI assigned
- Apr 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 021246 | NY | Primary |
Addresses
Primary practice location
750 Park PL
Long Beach, NY 11561-2110
Mailing address
2594 Norton PL
Bellmore, NY 11710-5412
Phone (516) 785-8633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021246 | Other | NY | LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021246 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BJK Inc | Past | Accepting new patients |
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": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568680155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2594 NORTON PL",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117105412",
"telephone_number": "516-785-8633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 PARK PL",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612110",
"telephone_number": "516-536-0800",
"fax_number": "516-889-8690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SILVA",
"first_name": "JERRY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "021246",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "021246",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.