Individual provider Active NPI

Marylynn Dandrea, RPH

  • Pharmacist
  • Rochester, NY
National Provider Identifier
1790960490
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
044162 Issued in NY
Practice address
1561 Long Pond Rd
Suite 104
Rochester, NY 14626-4117
Phone
(585) 723-7340
NPI assigned
Jan 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 044162 NY Primary

Addresses

Primary practice location

1561 Long Pond Rd
Suite 104
Rochester, NY 14626-4117

Mailing address

1561 Long Pond Rd
Suite 104
Rochester, NY 14626-4117
Phone (585) 723-7340

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
044162NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1199145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1790960490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 104",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-723-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "SUITE 104",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264117",
            "telephone_number": "585-723-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDREA",
        "first_name": "MARYLYNN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-01",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "044162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.