Individual provider Active NPI

Andrew William Caradona, RPH

  • Pharmacist
  • Lake Ronkonkoma, NY
National Provider Identifier
1821135567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
033984 Issued in NY
Practice address
640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324
Phone
(631) 471-1060
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 033984 NY Primary

Addresses

Primary practice location

640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324

Mailing address

107 Park Ave
Bay Shore, NY 11706-7310
Phone (631) 666-1937

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821135567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PARK AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067310",
            "telephone_number": "631-666-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792324",
            "telephone_number": "631-471-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARADONA",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "033984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.