Individual provider Active NPI

Jacqueline Limqueco Poblete

  • Pharmacotherapy Pharmacist
  • New York, NY
National Provider Identifier
1811219587
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
039726 Issued in NY
Practice address
120 W 106TH St
New York, NY 10025-3923
Phone
(212) 870-4993
Fax
(212) 870-4982
NPI assigned
Feb 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 039726 NY Primary

Addresses

Primary practice location

120 W 106TH St
New York, NY 10025-3923

Mailing address

120 W 106TH St
New York, NY 10025-3923
Phone (212) 870-4993

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
039726NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1811219587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253923",
            "telephone_number": "212-870-4993",
            "fax_number": "212-870-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253923",
            "telephone_number": "212-870-4993",
            "fax_number": "212-870-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLETE",
        "first_name": "JACQUELINE",
        "middle_name": "LIMQUECO",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NY",
            "license": "039726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.