Active NPI
Jeffreydan M Avena, PHARMD
- Pharmacist
- Wyncote, PA
National Provider Identifier
1912508680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP452701
- Practice address
- 1000 Easton Rd Ste 200
Wyncote, PA 19095-2900 - Phone
- (215) 887-8523
- NPI assigned
- Nov 8, 2020
- Last updated
- Nov 8, 2020
- 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 | RP452701 | PA | Primary |
Addresses
Primary practice location
1000 Easton Rd Ste 200
Wyncote, PA 19095-2900
Mailing address
730 Saint Albans St
Philadelphia, PA 19147-2819
Phone (845) 558-2193
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP452701 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604793600000",
"number": "1912508680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 SAINT ALBANS ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191472819",
"telephone_number": "845-558-2193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EASTON RD STE 200",
"city": "WYNCOTE",
"state": "PA",
"postal_code": "190952900",
"telephone_number": "215-887-8523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVENA",
"first_name": "JEFFREYDAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-08",
"last_updated": "2020-11-08",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP452701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyncote, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.