Individual provider Active NPI

Trevor Peter Yannace, PHARM.D.

  • Pharmacist
  • Clifton Park, NY
National Provider Identifier
1700190139
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
054701 Issued in NY
Practice address
15 Greenridge Dr
Clifton Park, NY 12065-6628
Phone
(516) 884-8253
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054701 NY Primary

Addresses

Primary practice location

15 Greenridge Dr
Clifton Park, NY 12065-6628

Mailing address

15 Greenridge Dr
Clifton Park, NY 12065-6628
Phone (516) 884-8253

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
054701NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1700190139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GREENRIDGE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656628",
            "telephone_number": "516-884-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GREENRIDGE DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656628",
            "telephone_number": "516-884-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNACE",
        "first_name": "TREVOR",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.