Active NPI
Jillian Taylor Wald, PHARMD, RPH
- Pharmacist
- Staten Island, NY
National Provider Identifier
1801369913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064351
- Practice address
- 4055 Hylan Blvd
Staten Island, NY 10308-3334 - Phone
- (718) 966-9285
- NPI assigned
- Jan 10, 2019
- Last updated
- Jan 10, 2019
- Sex
- Female
- 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 | 064351 | NY | Primary |
Addresses
Primary practice location
4055 Hylan Blvd
Staten Island, NY 10308-3334
Mailing address
142 Hitchcock Ave
Staten Island, NY 10306-1530
Phone (718) 530-4234
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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064351 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1801369913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 HITCHCOCK AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103061530",
"telephone_number": "718-530-4234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 HYLAN BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103083334",
"telephone_number": "718-966-9285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALD",
"first_name": "JILLIAN",
"middle_name": "TAYLOR",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.