Active NPI
Gary Stavin, RPH
- Pharmacist
- Woodhaven, NY
National Provider Identifier
1750604575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045178
- Practice address
- 8007 Jamaica Ave
Woodhaven, NY 11421-1902 - Phone
- (718) 296-0400
- Fax
- (718) 296-2815
- NPI assigned
- Mar 8, 2010
- Sex
- Male
- 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 | 045178 | NY | Primary |
Addresses
Primary practice location
8007 Jamaica Ave
Woodhaven, NY 11421-1902
Mailing address
2236 E 65TH St
Brooklyn, NY 11234-6320
Phone (718) 296-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02242419 | 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
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthmax Corporation | Current | Accepting new patients | |
| Healthmax Corporation | Pharmacist | Current | Accepting new patients |
Locations
8007 Jamaica Ave
Woodhaven, NY 11421
Phone (718) 296-0400
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": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1750604575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2236 E 65TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112346320",
"telephone_number": "718-296-0400",
"fax_number": "718-296-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8007 JAMAICA AVE",
"city": "WOODHAVEN",
"state": "NY",
"postal_code": "114211902",
"telephone_number": "718-296-0400",
"fax_number": "718-296-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVIN",
"first_name": "GARY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-08",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02242419",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodhaven, 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.