P D L Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

016022 Issued in NY

Legal business name

P D L DRUG STORE INC

Doing business as

Whites Drug and Department Store

Practice address

95 The PLZ
Montauk, NY 11954-4000

Phone

(631) 668-2994

Fax

(631) 668-1109

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Deryn Trott

Title

Vice President

Phone

(631) 668-2994

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Whites Drug and Department Store Doing business as

Locations

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1679603591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119540740",
            "telephone_number": "631-668-2994",
            "fax_number": "631-668-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 THE PLZ",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119544000",
            "telephone_number": "631-668-2994",
            "fax_number": "631-668-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P D L DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "TROTT",
        "authorized_official_first_name": "DERYN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "631-668-2994",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "016022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC. NUMBER",
            "identifier": "016022",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01425814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whites Drug and Department Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Montauk Drug Inc
• Montauk Medical Care PC
• Rosemary Moore, LMT
• Emma Nunez Friedberg, LCSW
• Barbara Ohayon, LMT
• Kellie Peterson
• Robroy Puetz, RPH
• Whitney L Reidlinger, OTR/L
• Meghan Anne Ryan, DPT
• Stefanie Sacks Dec, M.S., C.N.S, C.D.N

• Community/Retail Pharmacy in Montauk, NY
• Providers in Montauk, 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 Jul 15, 2024; 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.