Active NPI
Diane Fahey, RPH
- Pharmacist
- Glen Cove, NY
National Provider Identifier
1932380342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045123
- Practice address
- 11 Carlyle Dr
Glen Cove, NY 11542-1474 - Phone
- (516) 671-6286
- NPI assigned
- Nov 14, 2007
- Sex
- Female
- 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 | 045123 | NY | Primary |
Addresses
Primary practice location
11 Carlyle Dr
Glen Cove, NY 11542-1474
Mailing address
11 Carlyle Dr
Glen Cove, NY 11542-1474
Phone (516) 671-6286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01552267 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 045123 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1932380342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CARLYLE DR",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115421474",
"telephone_number": "516-671-6286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CARLYLE DR",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115421474",
"telephone_number": "516-671-6286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHEY",
"first_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-14",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01552267",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glen Cove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.