Individual provider Active NPI

Elizabeth Vaccaro, PHARMACIST

  • Pharmacist
  • Mattituck, NY
National Provider Identifier
1679757827
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
039651-1 Issued in NY
Practice address
195 Main Rd
Mattituck, NY 11952
Phone
(631) 298-5601
Fax
(631) 298-3598
NPI assigned
Dec 24, 2007
Last updated
Dec 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 039651-1 NY Primary

Addresses

Primary practice location

195 Main Rd
Mattituck, NY 11952

Mailing address

PO Box 1589
Mattituck, NY 11952-0903
Phone (631) 298-5601

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

LicenseStateTypeSpecialty
039651-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1679757827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119520903",
            "telephone_number": "631-298-5601",
            "fax_number": "631-298-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "11952",
            "telephone_number": "631-298-5601",
            "fax_number": "631-298-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "039651-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; 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.