Individual provider Active NPI

Jeffrey Niedelman, RPH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1902989841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
041920 Issued in NY
Practice address
9422 Avenue L
Brooklyn, NY 11236-4809
Phone
(718) 251-1313
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

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 041920 NY Primary

Addresses

Primary practice location

9422 Avenue L
Brooklyn, NY 11236-4809

Mailing address

18 Magpie LN
Levittown, NY 11756-3223

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
041920NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Zenith Pharmacy Inc. Current Accepting new patients
Bluesman Pharmacy Inc Current Accepting new patients

Locations

9422 Avenue L
Brooklyn, NY 11236
Phone (718) 251-1313

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902989841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MAGPIE LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9422 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364809",
            "telephone_number": "718-251-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDELMAN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "041920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, 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.