Individual provider Active NPI

Philip Joseph Daddona, PHARMACIST

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1922289933
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31579 Issued in NY
Practice address
4368 Amboy Rd
Staten Island, NY 10312-3820
Phone
(718) 227-3049
Fax
(718) 227-3056
NPI assigned
Nov 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 31579 NY Primary

Addresses

Primary practice location

4368 Amboy Rd
Staten Island, NY 10312-3820

Mailing address

118 Battery Ave
Apt 2 D
Brooklyn, NY 11209-6404
Phone (718) 833-1560

Other identifiers 1

IdentifierTypeStateIssuer
18MedicaidNY

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
31579NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1922289933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BATTERY AVE",
            "address_2": "APT 2 D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096404",
            "telephone_number": "718-833-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123820",
            "telephone_number": "718-227-3049",
            "fax_number": "718-227-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADDONA",
        "first_name": "PHILIP",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "31579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18",
            "state": "NY"
        }
    ],
    "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 Nov 19, 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.