Individual provider Active NPI

Marc David Winnegrad, R.PH.

  • Pharmacist
  • New York, NY
National Provider Identifier
1700067899
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
035004 Issued in NY
Practice address
380 Amsterdam Ave
New York, NY 10024-6208
Phone
(212) 579-7246
NPI assigned
Nov 17, 2007
Last updated
Nov 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 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 035004 NY Primary

Addresses

Primary practice location

380 Amsterdam Ave
New York, NY 10024-6208

Mailing address

4 Linford CT
Marlboro, NJ 07746-2706
Phone (732) 625-9387

Other identifiers 1

IdentifierTypeStateIssuer
02901908MedicaidNY

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
035004NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1700067899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LINFORD CT",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462706",
            "telephone_number": "732-625-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246208",
            "telephone_number": "212-579-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNEGRAD",
        "first_name": "MARC",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "035004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02901908",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.