Jeffrey L Gedacht, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

0304771 Issued in NY

Practice address

750 Park PL
Long Beach, NY 11561-2110

Phone

(516) 889-8770

Fax

(516) 889-8225

NPI assigned

Mar 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1598089328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 S END",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981025",
            "telephone_number": "516-569-0492",
            "fax_number": "516-889-8225"
        },
        {
            "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": "516-889-8770",
            "fax_number": "516-889-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDACHT",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0304771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS  PHARMACIST LICENSE NUMBER",
            "identifier": "0304771",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.