Individual provider Active NPI

Milan Michael Sivacek, R.PH.

  • Psychiatric Pharmacist
  • Brentwood, NY
National Provider Identifier
1821241704
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric PharmacistTaxonomy code 1835P1300X
License
029340 Issued in NY
Practice address
998 Crooked Hill Rd
Brentwood, NY 11717-1019
Phone
(631) 761-2295
Fax
(631) 761-2298
NPI assigned
Oct 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Pharmacist 1835P1300X 029340 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Brentwood, NY 11717-1019

Mailing address

84 Stoothoff Rd
East Northport, NY 11731-3920
Phone (631) 368-3341

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
029340NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1821241704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 STOOTHOFF RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313920",
            "telephone_number": "631-368-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-2295",
            "fax_number": "631-761-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVACEK",
        "first_name": "MILAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "NY",
            "license": "029340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.