Alex Jijy James
Individual provider Active NPI Pharmacist · Bardonia, NY
NPI 1649901174 · NPPES record last updated Jun 24, 2022
Key facts
- NPI
- 1649901174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 069121 (NY)
- Practice address
- 167 Ny-304
Bardonia, NY 12553 - Phone
- (845) 624-8080
- Fax
- (845) 624-8055
- NPI assigned
- Jun 24, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069121 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 069121 | NY | Yes |
Addresses
Primary practice location
167 Ny-304
Bardonia, NY 12553
Mailing address
2506 Constitution Way
New Windsor, NY 12553-4922
Phone (845) 567-1119
Other providers in Bardonia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.