Active NPI
Jacqueline Bardini
- Pharmacist
- Mohegan Lake, NY
National Provider Identifier
1649593575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 039405
- Practice address
- 1775 E Main St
Mohegan Lake, NY 10547-1356 - Phone
- (914) 528-5159
- NPI assigned
- Mar 6, 2010
- Last updated
- Mar 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 039405 | NY | Primary |
| Pharmacist | 183500000X | PCT.0008917 | CT |
Addresses
Primary practice location
1775 E Main St
Mohegan Lake, NY 10547-1356
Mailing address
18 Fairways LN
Beacon, NY 12508-7018
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0008917 | CT | MD | Pharmacist |
| 039405 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267833600000",
"number": "1649593575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 FAIRWAYS LN",
"city": "BEACON",
"state": "NY",
"postal_code": "125087018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 E MAIN ST",
"city": "MOHEGAN LAKE",
"state": "NY",
"postal_code": "105471356",
"telephone_number": "914-528-5159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDINI",
"first_name": "JACQUELINE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-06",
"last_updated": "2010-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "039405",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0008917",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mohegan Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.