Active NPI
Douglas Gradel
- Pharmacist
- Northport, NY
National Provider Identifier
1831967108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 070956
- Practice address
- 3 Trescott Path
Northport, NY 11768-2535 - Phone
- (631) 617-8768
- NPI assigned
- Dec 18, 2023
- Sex
- Male
- 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 | 070956 | NY | Primary |
Addresses
Primary practice location
3 Trescott Path
Northport, NY 11768-2535
Mailing address
3 Trescott Path
Northport, NY 11768-2535
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070956 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1831967108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 TRESCOTT PATH",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117682535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 TRESCOTT PATH",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117682535",
"telephone_number": "631-617-8768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADEL",
"first_name": "DOUGLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-18",
"last_updated": "2023-12-18",
"certification_date": "2023-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "070956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.