Active NPI
Edward J Brancale, PHARMACIST
- Pharmacist
- Staten Island, NY
National Provider Identifier
1891919015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 033968
- Practice address
- 1300 Clove Rd
Staten Island, NY 10301-4302 - Phone
- (718) 727-0022
- Fax
- (718) 727-3316
- NPI assigned
- Apr 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 033968 | NY | Primary |
Addresses
Primary practice location
1300 Clove Rd
Staten Island, NY 10301-4302
Mailing address
576 Edgegrove Ave
Staten Island, NY 10312-2765
Phone (718) 356-0682
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 |
|---|---|---|---|
| 033968 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Classic Pharmacy Inc | Current | Accepting new patients | |
| Marine Pharmacy Inc | Current | Accepting new patients |
Locations
1300 Clove Rd
Staten Island, NY 10301
Phone (718) 727-0022
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Staten Island, NY
- NPI 1093757874
-
- Community/Retail Pharmacy
- Brooklyn, NY
- NPI 1235298795
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891919015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 EDGEGROVE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103122765",
"telephone_number": "718-356-0682",
"fax_number": "718-727-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 CLOVE RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103014302",
"telephone_number": "718-727-0022",
"fax_number": "718-727-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCALE",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "033968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, 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.