Individual provider Active NPI

Marc Alan Wastell, R.PH.,M.S.D.C.

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1730366493
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33604 Issued in NY
Practice address
2112 White Plains Rd
Bronx, NY 10462-1404
Phone
(718) 597-3000
Fax
(718) 597-7842
NPI assigned
Jan 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33604 NY Primary

Addresses

Primary practice location

2112 White Plains Rd
Bronx, NY 10462-1404

Mailing address

2112 White Plains Rd
Bronx, NY 10462-1404
Phone (718) 597-3000

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
009228NYMDPsychologist
33604NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1730366493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621404",
            "telephone_number": "718-597-3000",
            "fax_number": "718-597-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621404",
            "telephone_number": "718-597-3000",
            "fax_number": "718-597-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASTELL",
        "first_name": "MARC",
        "middle_name": "ALAN",
        "credential": "R.PH.,M.S.D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "33604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

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

Verify at the official NPI Registry.