Dedale Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022517 Issued in NY

Legal business name

DEDALE PHARMACY INC

Doing business as

Dale Drug

Practice address

531 W Merrick Rd
Valley Stream, NY 11580-5125

Phone

(516) 561-1222

Fax

(516) 561-1223

NPI assigned

Feb 27, 2007

Last updated

Aug 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Devivo, RPHNPI 1396036497

Title

Pres

Phone

(516) 561-1222

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• DALE DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Michael Devivo

  • Pharmacist
  • Valley Stream, NY
  • NPI 1396036497
  NPD Authorized official
• Sandeep Dhamija

  • Pharmacist
  • Valley Stream, NY
  • NPI 1942621974
  NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1649306044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805125",
            "telephone_number": "516-561-1222",
            "fax_number": "516-561-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805125",
            "telephone_number": "516-561-1222",
            "fax_number": "516-561-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDALE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "DEVIVO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "516-561-1222",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "022517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01554829",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2057449",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DALE DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Connie Dcosta, FNP
• Nicole De Los Santos
• Richard Deangelis, D.C.
• Omawathi Debidat
• Jessica Decelian
• Deeper Well Counseling LCSW PC
• Derida Deflorimonte, MHC-LP
• Irene Sachs Deitel, APRN,BC
• Deborah Michelle Dejean, LMHC
• Anita Delahoz

• Community/Retail Pharmacy in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.