Active NPI
Christine Petrunoff
- Pharmacist
- Oceanside, NY
National Provider Identifier
1972781151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 040786
- Practice address
- 3620 Long Beach Rd
Oceanside, NY 11572-5705 - Phone
- (516) 766-3514
- NPI assigned
- Feb 9, 2008
- Last updated
- Feb 9, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 040786 | NY | Primary |
Addresses
Primary practice location
3620 Long Beach Rd
Oceanside, NY 11572-5705
Mailing address
8543 107TH St
Richmond Hill, NY 11418-1142
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040786 | Other | NY | LISCENSE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waldbaum 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": "1202515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202515200000",
"number": "1972781151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8543 107TH ST",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "114181142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3620 LONG BEACH RD",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115725705",
"telephone_number": "516-766-3514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRUNOFF",
"first_name": "CHRISTINE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-09",
"last_updated": "2008-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "040786",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISCENSE",
"identifier": "040786",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.