Individual provider Active NPI

Clifton Frederick Bangaree, PHARM.D

  • Pharmacist
  • Forest Hills, NY
National Provider Identifier
1609385319
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063136 Issued in NY
Practice address
6352 108TH St
Forest Hills, NY 11375-1350
Phone
(516) 643-3939
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063136 NY Primary

Addresses

Primary practice location

6352 108TH St
Forest Hills, NY 11375-1350

Mailing address

120 Hanson PL
Malverne, NY 11565-1747
Phone (516) 643-3939

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
063136NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1609385319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HANSON PL",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651747",
            "telephone_number": "516-643-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6352 108TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751350",
            "telephone_number": "516-643-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGAREE",
        "first_name": "CLIFTON",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.