Josip Bacic, PHARM D
Individual provider Active NPI Pharmacist · College Point, NY
NPI 1619158243 · NPPES record last updated Nov 29, 2007
Key facts
- NPI
- 1619158243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 050517 (NY)
- Practice address
- 1508 College Point Blvd
College Point, NY 11356-2210 - Phone
- (718) 445-5800
- NPI assigned
- Nov 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050517 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 050517 | NY | Yes |
Addresses
Primary practice location
1508 College Point Blvd
College Point, NY 11356-2210
Mailing address
1508 College Point Blvd
College Point, NY 11356-2210
Phone (718) 445-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00636360 | Medicaid | NY |
Other providers in College Point, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.