DIANA KEDDIS (NPI# 1447734330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447734330 |
| Entity Type | Individual |
| Full Name | DIANA KEDDIS |
| Practice Address |
252 Port Richmond Ave Ste B Staten Island NY 10302-1740 |
| Mailing Address |
252 Port Richmond Ave Staten Island NY 10302-1749 |
| Practice Telephone | 7185560942 |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Street Address |
252 PORT RICHMOND AVE STE B |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10302-1740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255794343 | Polina Glazman | Pharmacist | 252 Port Richmond Ave Ste B, Staten Island, NY 10302-1740 | 2016-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494174 | Denasia Fitch | Student in an Organized Health Care Education/Training Program | 80 Willowbrook Rd, Staten Island, NY 10302 | 2019-08-26 |
| 1548752983 | Lawan Rickenbacker | Counselor | 28 Treadwell Ave, Staten Island, NY 10302 | 2018-06-01 |
| 1275059321 | Omolara Rachael Adediji | Nurse Practitioner | 210 Trantor Place, Apt 1d, Staten Island, NY 10302 | 2017-08-21 |
| 1558893479 | Joseph Wilson | Substance Abuse Rehabilitation Facility | 273 Heberton Avenue, Staten Island, NY 10302 | 2017-03-30 |
| 1902358864 | Natalie Valencia Toney-zubairu | Nurse Practitioner | Community Health Center of Richmond, 235 Port Richmond Ave, Staten Island, NY 10302 | 2016-10-26 |
| 1912453788 | Adewunmi Bankole | Registered Nurse | 124 Nicholas Avenue Apt B, Staten Island, NY 10302 | 2016-08-31 |
| 1154788974 | Eileen Patricia Cameron | Counselor | 263-267 Port Richmond Aveune, Staten Island, NY 10302 | 2016-01-25 |
| 1225468432 | Total Dental Care of Staten Island, P.C. | Dentist | 135 Willowbrook Road, Staten Island, NY 10302 | 2013-11-25 |
| 1760723621 | Si. Senior Lifestyle Center Inc | Clinic/Center | 98 Port Richmond Ave, Staten Island, NY 10302 | 2013-03-01 |
| 1962751255 | Kathleen Gomez-rodriguez | Speech-Language Pathologist | 12 Crystal Ave, Staten Island, NY 10302 | 2012-09-03 |
| Find all providers in zip 10302 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609351956 | Ismaeel Pharmacy Inc | Pharmacy | 280 Broadway # Store1, Staten Island, NY 10310-2055 | 2018-10-02 |
| 1487132064 | Bay Rx Inc | Pharmacy | 47 Broad St, Staten Island, NY 10304-2608 | 2018-08-05 |
| 1053805788 | Castleton Chemists LLC | Pharmacy | 831 Castleton Ave, Staten Island, NY 10310 | 2018-06-16 |
| 1275043200 | Gvm Pharmacy Inc | Pharmacy | 203 Old Town Rd, Staten Island, NY 10305-1415 | 2017-10-04 |
| 1881068971 | Enjoy Pharmaceutical Services | Pharmacy | 3927 Amboy Rd, Staten Island, NY 10308-2421 | 2015-11-30 |
| 1851762256 | Regal Remedies Rx Inc | Pharmacy | 19a Olympia Blvd, Staten Island, NY 10305-4309 | 2015-10-12 |
| 1477923266 | Mannix Family Market At Veterans Road LLC | Pharmacy | 3010 Veterans Rd W, Staten Island, NY 10309-2510 | 2015-10-06 |
| 1407285216 | Richmond Valley Pharmacy Inc | Pharmacy | 4888 Arthur Kill Rd, Staten Island, NY 10309-2633 | 2013-11-02 |
| 1003250614 | Health Aid Pharmacy II Inc | Pharmacy | 1781 Richmond Rd, Staten Island, NY 10306-2524 | 2013-04-25 |
| 1982940763 | Staten Island Pharmacy Inc. | Pharmacy | 1807 Victory Blvd, Staten Island, NY 10314-3515 | 2012-12-23 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10302 |
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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.