Individual provider Active NPI

John Prusak

  • Pharmacist
  • Binghamton, NY
National Provider Identifier
1568785301
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0482751 Issued in NY
Practice address
1276 Upper Front St
Binghamton, NY 13901-1011
Phone
(607) 722-4324
NPI assigned
Mar 8, 2010
Last updated
Mar 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 0482751 NY Primary

Addresses

Primary practice location

1276 Upper Front St
Binghamton, NY 13901-1011

Mailing address

531 Glen Mary Dr
Owego, NY 13827-2009
Phone (804) 512-1398

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

LicenseStateTypeSpecialty
0482751NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1568785301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 GLEN MARY DR",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138272009",
            "telephone_number": "804-512-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 UPPER FRONT ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011011",
            "telephone_number": "607-722-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSAK",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0482751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.