Individual provider Active NPI

Philip Polonet, PHARMACIST

  • Pharmacist
  • Mineola, NY
National Provider Identifier
1639351034
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
025021-1 Issued in NY
Practice address
52 Jericho Tpke
Mineola, NY 11501-2930
Phone
(516) 873-2020
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 025021-1 NY Primary

Addresses

Primary practice location

52 Jericho Tpke
Mineola, NY 11501-2930

Mailing address

52 Jericho Tpke
Mineola, NY 11501-2930
Phone (516) 873-2020

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

State licenses

LicenseStateTypeSpecialty
025021-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1639351034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012930",
            "telephone_number": "516-873-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012930",
            "telephone_number": "516-873-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONET",
        "first_name": "PHILIP",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "025021-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.