Individual provider Active NPI

David Verdine, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Newark, NY
National Provider Identifier
1609330885
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
059262 Issued in NY
Practice address
1200 Driving Park Ave
Newark, NY 14513-1090
Phone
(315) 332-2204
Fax
(315) 332-2428
NPI assigned
Jan 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 059262 NY Primary

Addresses

Primary practice location

1200 Driving Park Ave
Newark, NY 14513-1090

Mailing address

1200 Driving Park Ave
Newark, NY 14513-1090
Phone (315) 332-2204

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
059262NYMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1609330885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131090",
            "telephone_number": "315-332-2204",
            "fax_number": "315-332-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131090",
            "telephone_number": "315-332-2204",
            "fax_number": "315-332-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDINE",
        "first_name": "DAVID",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "059262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.