Katelyn Faughnan, PHARMD

Key facts

NPI

1629525902

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

062256 (NY)

Practice address

4 Main St
Schaghticoke, NY 12154

Phone

(518) 753-0149

Fax

(518) 753-9812

NPI assigned

Sep 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 1, 2018.

{
    "created_epoch": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1629525902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MAIN ST",
            "city": "SCHAGHTICOKE",
            "state": "NY",
            "postal_code": "121542733",
            "telephone_number": "518-753-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MAIN ST",
            "city": "SCHAGHTICOKE",
            "state": "NY",
            "postal_code": "12154",
            "telephone_number": "518-753-0149",
            "fax_number": "518-753-9812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 W Main St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531771",
            "country_code": "US",
            "telephone_number": "518-483-3990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 Main St",
            "address_purpose": "LOCATION",
            "city": "Owego",
            "state": "NY",
            "postal_code": "138271779",
            "country_code": "US",
            "telephone_number": "607-687-0891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAUGHNAN",
        "first_name": "KATELYN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064456",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "062256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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