Active NPI
Terry Stefanou
- Pharmacist
- Wantagh, NY
National Provider Identifier
1780860114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049211
- Practice address
- 3712 Jerusalem Ave
Wantagh, NY 11793-2008 - Phone
- (516) 220-4790
- Fax
- (516) 795-4059
- NPI assigned
- Jan 16, 2008
- Last updated
- May 29, 2020
- Sex
- Male
- 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 | 049211 | NY | Primary |
Addresses
Primary practice location
3712 Jerusalem Ave
Wantagh, NY 11793-2008
Mailing address
5125 Merrick Rd
Massapequa Park, NY 11762-3728
Phone (516) 798-7676
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
| License | State | Type | Specialty |
|---|---|---|---|
| 049211 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1780860114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5125 MERRICK RD",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117623728",
"telephone_number": "516-798-7676",
"fax_number": "516-795-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3712 JERUSALEM AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117932008",
"telephone_number": "516-220-4790",
"fax_number": "516-795-4059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEFANOU",
"first_name": "TERRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-16",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "049211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.