Individual provider Active NPI

Dolores Cordova Miranda, RPH

  • Pharmacist
  • New York, NY
National Provider Identifier
1740503606
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050802 Issued in NY
Practice address
1901 1St Ave
New York, NY 10029-7404
Phone
(212) 423-7420
Fax
(212) 423-6661
NPI assigned
Mar 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 050802 NY Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7404

Mailing address

116 E Jersey St
2ND Floor
Elizabeth, NJ 07206-1707
Phone (908) 659-0474

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
050802NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1740503606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E JERSEY ST",
            "address_2": "2ND FLOOR",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061707",
            "telephone_number": "908-659-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-7420",
            "fax_number": "212-423-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DOLORES",
        "middle_name": "CORDOVA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050802",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 8, 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.