Active NPI
Betty Chacko, RPH
- Pharmacist
- Glen Oaks, NY
National Provider Identifier
1760704548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051494
- Practice address
- 25405 Hillside Ave
Glen Oaks, NY 11004-1613 - Phone
- (718) 347-7312
- NPI assigned
- Feb 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 051494 | NY | Primary |
Addresses
Primary practice location
25405 Hillside Ave
Glen Oaks, NY 11004-1613
Mailing address
6 Gordon Drive
Williston Park, NY 11596
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051494 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266796800000",
"number": "1760704548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 GORDON DRIVE",
"city": "WILLISTON PARK",
"state": "NY",
"postal_code": "11596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25405 HILLSIDE AVE",
"city": "GLEN OAKS",
"state": "NY",
"postal_code": "110041613",
"telephone_number": "718-347-7312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACKO",
"first_name": "BETTY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-22",
"last_updated": "2010-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "051494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Oaks, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.