Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

021142 Issued in NY

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

101 Wicks Rd
Brentwood, NY 11717-3523

Phone

(631) 436-7522

Fax

(631) 436-7541

NPI assigned

Sep 20, 2006

Last updated

Aug 11, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC & PACIFIC TEA CO., INC.As reported in NPPES

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

Authorized official

Name

Susan D Kijowski

Title

Manager, Regulatory Compliance

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Great Atlantic & Pacific Tea Company Inc

  dba A & P Pharmacy

  • Pharmacy
  • Allendale, NJ
  • NPI 1962427526

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ralph Thomas Gibson, RPH

  • Pharmacist
  • Brentwood, NY
  • NPI 1356519854
  NPD (past)
• Deborah Anne Zschau, RPH

  • Pharmacist
  • Brentwood, NY
  • NPI 1336317452
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1861599631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700",
            "fax_number": "201-571-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WICKS RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173523",
            "telephone_number": "631-436-7522",
            "fax_number": "631-436-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO., INC.",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER, REGULATORY COMPLIANCE",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "021142",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "021142",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01272155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3399739",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Manjiri Pande, DMD
• Monique Pascual, D.C.
• John Gabriel Passarelli, MD
• Akashkumar Dineshbhai Patel
• Manilal I Patel, DDS
• Patricia Pena Arce,DDS,PC
• Carmela Mae Q Patrimonio, PTA, PT
• Rose E Paul
• Peak Chiropractic, PC
• Shanae Olivia Peartewers

• Pharmacy in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.