Individual provider Active NPI

Natalie Anne Slobodian, PHARMD

  • Pharmacist
  • Waterville, NY
National Provider Identifier
1649457102
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050354-1 Issued in NY
Practice address
268 Sanger Ave
Waterville, NY 13480-1122
Phone
(315) 841-4447
Fax
(315) 841-4135
NPI assigned
Jan 28, 2008
Last updated
Jan 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 050354-1 NY Primary

Addresses

Primary practice location

268 Sanger Ave
Waterville, NY 13480-1122

Mailing address

268 Sanger Ave
Waterville, NY 13480-1122
Phone (315) 841-4447

Other identifiers 1

IdentifierTypeStateIssuer
00827812MedicaidNY

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
050354-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1649457102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 SANGER AVE",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134801122",
            "telephone_number": "315-841-4447",
            "fax_number": "315-841-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 SANGER AVE",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134801122",
            "telephone_number": "315-841-4447",
            "fax_number": "315-841-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOBODIAN",
        "first_name": "NATALIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050354-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00827812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, NY

Sources for this page

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