Individual provider Active NPI

Krystal M Nieckarz

  • Pharmacist
  • Albany, NY
National Provider Identifier
1922248640
Registry record updated Feb 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053007-1 Issued in NY
Practice address
310 S Pearl St
Albany, NY 12202-1940
Phone
(518) 465-6008
NPI assigned
Feb 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053007-1 NY Primary

Addresses

Primary practice location

310 S Pearl St
Albany, NY 12202-1940

Mailing address

3162 E Lydius St
Schenectady, NY 12303-5035

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

LicenseStateTypeSpecialty
053007-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235174400000",
    "number": "1922248640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3162 E LYDIUS ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123035035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S PEARL ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021940",
            "telephone_number": "518-465-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIECKARZ",
        "first_name": "KRYSTAL",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-21",
        "last_updated": "2009-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053007-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2009; 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.