Active NPI
Charles Anthony Ciaccio, RPH
- Pharmacist
- Middle Village, NY
National Provider Identifier
1952429284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042144
- Practice address
- 6459 Dry Harbor Rd
Middle Village, NY 11379-2392 - Phone
- (718) 806-1455
- Fax
- (718) 806-1151
- NPI assigned
- Mar 26, 2007
- Last updated
- Jun 25, 2010
- 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 | 042144 | NY | Primary |
Addresses
Primary practice location
6459 Dry Harbor Rd
Middle Village, NY 11379-2392
Mailing address
64-59 Dry Harbor Rd
Queens, NY 11379-1853
Phone (718) 806-1455
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 |
|---|---|---|---|
| 042144 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harbor Apothecary Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1952429284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64-59 DRY HARBOR RD",
"city": "QUEENS",
"state": "NY",
"postal_code": "113791853",
"telephone_number": "718-806-1455",
"fax_number": "718-806-1151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6459 DRY HARBOR RD",
"city": "MIDDLE VILLAGE",
"state": "NY",
"postal_code": "113792392",
"telephone_number": "718-806-1455",
"fax_number": "718-806-1151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIACCIO",
"first_name": "CHARLES",
"middle_name": "ANTHONY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.