Individual provider Active NPI

Nicole Marie Campanella I, R.PH.

  • Pharmacist
  • New York, NY
National Provider Identifier
1629282157
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
048766 Issued in NY
Practice address
1200 1St Ave
New York, NY 10021-7105
Phone
(212) 734-6998
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048766 NY Primary

Addresses

Primary practice location

1200 1St Ave
New York, NY 10021-7105

Mailing address

7920 69TH Rd
Middle Village, NY 11379-2919
Phone (718) 326-0553

Other names 1

  • Ms. Nicole Marie Marmora Former name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
048766NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
VBVS Pharmacy Inc PastSince Jul 2, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1629282157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 69TH RD",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792919",
            "telephone_number": "718-326-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217105",
            "telephone_number": "212-734-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANELLA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MARMORA",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "R.PH.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.