Waldbaum Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

023701 Issued in NY

Legal business name

WALDBAUM INC

Practice address

5508 Sunrise Hwy
Massapequa, NY 11758-5328

Phone

(516) 797-9672

Fax

(516) 797-9674

NPI assigned

Jul 13, 2006

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INCAs reported in NPPES

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

Authorized official

Name

Susan Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• WALDBAUMS PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Buonaguro, RPH

  • Pharmacist
  • Massapequa, NY
  • NPI 1295903813
  NPD (past)
• Cheryl Marcia Cantor, RPH

  • Pharmacist
  • Massapequa, NY
  • NPI 1417125360
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1649295296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585328",
            "telephone_number": "516-797-9672",
            "fax_number": "516-797-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDBAUM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "023701",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "023701",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3341295",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01858373",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDBAUMS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Virga, D.D.S.
• Jennifer Marie Voigt
• Janet Vollmer Peters, MS,CCC,LSP
• Jannine Waight
• Wal-Mart Stores East LP
• Waldbaum Inc
• Walgreen Co
• Abigale Elizabeth Walker, MHC-LP
• Wallace B Kalt MD PC
• Jessica Wallace, LMSW

• Pharmacy in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.