Individual provider Active NPI

Raymond S Bacci, R.PH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1992900138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
040086 Issued in NY
Practice address
6109 5TH Ave
Brooklyn, NY 11220-4609
Phone
(718) 492-0900
Fax
(718) 439-3738
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 040086 NY Primary

Addresses

Primary practice location

6109 5TH Ave
Brooklyn, NY 11220-4609

Mailing address

2 Crosswicks Rd
Freehold, NJ 07728-3009
Phone (732) 577-6533

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

LicenseStateTypeSpecialty
040086NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jim & Phil'S Family Pharmacy LTD. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992900138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROSSWICKS RD",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283009",
            "telephone_number": "732-577-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204609",
            "telephone_number": "718-492-0900",
            "fax_number": "718-439-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCI",
        "first_name": "RAYMOND",
        "middle_name": "S",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.