Individual provider Active NPI

Abdo Al-Dalaim

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1780130922
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
062105 Issued in NY
Practice address
1207 White Plains Rd
Bronx, NY 10472-4903
Phone
(718) 409-1338
Fax
(718) 409-4684
NPI assigned
Aug 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 062105 NY Primary

Addresses

Primary practice location

1207 White Plains Rd
Bronx, NY 10472-4903

Mailing address

780 Pelham Pkwy S Apt A11
Bronx, NY 10462-1103
Phone (347) 220-5441

Other practice location 1

1263 Leland AV Apt #3C
Bronx, NY 10472
Phone (347) 220-5441

Other practice location 2

780 Pelham Pkwy S Apt A11
Bronx, NY 10462-1103
Phone (347) 220-5441

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

State licenses

LicenseStateTypeSpecialty
062105NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Yj Pharmacy Inc PastSince May 7, 2023 Accepting new patients

Organizations & group practices 1

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1780130922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 PELHAM PKWY S APT A11",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621103",
            "telephone_number": "347-220-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104724903",
            "telephone_number": "718-409-1338",
            "fax_number": "718-409-4684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1263 Leland AV Apt #3C",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10472",
            "country_code": "US",
            "telephone_number": "347-220-5441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "780 Pelham Pkwy S Apt A11",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104621103",
            "country_code": "US",
            "telephone_number": "347-220-5441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-DALAIM",
        "first_name": "ABDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "062105",
            "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 Jun 7, 2019; 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.