WAKEFIELD PHARMACY INC. (NPI# 1619195898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619195898 |
| Entity Type | Organization |
| Organization Name | WAKEFIELD PHARMACY INC. |
| Other Organization Name | QUEENS WAKEFIELD PHARMACY |
| Practice Address |
13525 Lefferts Blvd South Ozone Park NY 11420-3601 |
| Practice Telephone | 7188433900 |
| Practice Fax Number | 7188436044 |
| Mailing Telephone | 7188433900 |
| Mailing Fax Number | 7188436044 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT THOMAS MASON (PHARMACIST) |
| Authorized Official Telephone | 7188433900 |
| Authorized Official Credential | RPH-BS-MS-PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 30920 | NY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | STORE STATE LICENSE NO. | 017693 | 01 |
| NY | NAPB NUMBER | 3375816 | 01 |
| NY | DEA NUMBER | AW9809419 | 01 |
| Other Name | Type Code |
|---|---|
| Queens Wakefield Pharmacy | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | WAKEFIELD PHARMACY INC. | 135-25 Lefferts Blvd, So. Ozone Park, New York 11420-3601 |
| Virginia Business Entities | WAKEFIELD PHARMACY INC. | 105 Railroad Ave, Po Box 667, Wakefield, Virginia 23888 |
| Street Address |
13525 LEFFERTS BLVD |
| City | SOUTH OZONE PARK |
| State | NY |
| Zip Code | 11420-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013230531 | Robert T Mason | Pharmacist | 13525 Lefferts Blvd, South Ozone Park, NY 11420-3601 | 2010-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652934 | Elijah Roberto Tavarez | Counselor | 10810 Rockaway Blvd, South Ozone Park, NY 11420 | 2020-09-01 |
| 1285247353 | Carlene Evans | Counselor | 109 -18 Rockaway Blvd, Ozone Park, NY 11420 | 2020-08-28 |
| 1558973636 | Alisa Montgomery | Counselor | 108-19 Rockaway Blvd., South Ozone, NY 11420 | 2020-08-19 |
| 1194380451 | Janette Homecare of New York | Registered Nurse | 126-16 111th Avenue, South Ozone Park, NY 11420 | 2019-05-02 |
| 1255994364 | Jasoda Girdhari Ali | Physician Assistant | 132 12 Linden Blvd, South Ozone Park, NY 11420 | 2019-04-16 |
| 1144794553 | Levinia Melaram | Nurse Practitioner | 12234 149th Ave Fl 2, South Ozone Park, NY 11420 | 2019-01-18 |
| 1558848572 | Avinell Shane Abdool | Physician Assistant | 109-42-111th Street, South Ozone Park, NY 11420 | 2018-07-23 |
| 1427556703 | Shari Dimple Mohan | Specialist | 132-52 114 Street, South Ozone Park, NY 11420 | 2018-01-31 |
| 1831625375 | Yes We Can Speech Language Pathologist LLC | Case Management | 111-58 Leffert Blvd, 2f, South Ozone Park, NY 11420 | 2017-05-03 |
| 1992255350 | Community Cardiovascular Services, Pllc | Internal Medicine | 117-44, 122nd Street, South Ozone Park, NY 11420 | 2016-10-10 |
| Find all providers in zip 11420 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336132 | Manpreet Kaur | Pharmacist | 11424 126th St, South Ozone Park, NY 11420-2124 | 2018-11-27 |
| 1366765877 | Rathindra Kumar Roy | Pharmacist | 13026 Rockaway Blvd, South Ozone Park, NY 11420-2930 | 2010-03-11 |
| 1184946824 | Charles Stich | Pharmacist | 131-07 Rockaway Blvd, South Ozone Park, NY 11420 | 2010-02-23 |
| 1962641829 | Shelly Reshma Alli | Pharmacist | 15015 115th St, Wakefield, South Ozone Park, NY 11420-3920 | 2009-02-16 |
| 1649805847 | Latchman Bisram | Pharmacist | 11902 Rockaway Blvd, South Ozone Park, NY 11420-2422 | 2020-03-08 |
| 1659850402 | Natalie Mashall | Pharmacist | 10819 Rockaway Blvd, South Ozone Park, NY 11420-1034 | 2018-08-13 |
| 1588114797 | George Varghese | Pharmacist | 13124 Rockaway Blvd, Park Health Pharmacy, South Ozone Park, NY 11420-2932 | 2016-10-12 |
| 1275994436 | Timothy Francis Beck | Pharmacist | 11902 Rockaway Blvd, South Ozone Park, NY 11420-2422 | 2016-03-16 |
| 1073999561 | Afsana Hossain | Pharmacist | 11902 Rockaway Blvd, South Ozone Park, NY 11420-2422 | 2015-08-06 |
| 1700161692 | Syed M Ali | Pharmacist | 11902 Rockaway Blvd, South Ozone Park, NY 11420-2422 | 2011-10-11 |
| Find all providers in SOUTH OZONE PARK | ||||
| City | SOUTH OZONE PARK |
| Zip Code | 11420 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.