Active NPI
Basma Speregon
- Pharmacist
- Hauppauge, NY
National Provider Identifier
1730357344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042531
- Practice address
- 1236 Veterans Hwy
Hauppauge, NY 11788-3049 - Phone
- (631) 979-3547
- NPI assigned
- Feb 16, 2008
- Last updated
- Feb 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042531 | NY | Primary |
Addresses
Primary practice location
1236 Veterans Hwy
Hauppauge, NY 11788-3049
Mailing address
153 Geery Ave
Holbrook, NY 11741-1121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042531 | Other | NY | 042531LICENCE NY |
| 02278366 | Medicaid | NY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waldbaum Inc | Past | Accepting new patients | |
| Waldbaum Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203120000000",
"number": "1730357344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 GEERY AVE",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117411121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1236 VETERANS HWY",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117883049",
"telephone_number": "631-979-3547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEREGON",
"first_name": "BASMA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-16",
"last_updated": "2008-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042531",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "042531LICENCE NY",
"identifier": "042531",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02278366",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.