DR. JEFFREY FUDIN (NPI# 1679667117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679667117 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY FUDIN |
| Credential | PHARM.D. |
| Practice Address |
113 Holland Ave Albany NY 12208-3410 |
| Mailing Address |
357 Delaware Ave Unit 214 Delmar NY 12054-6208 |
| Practice Telephone | 5185885651 |
| Mailing Telephone | 5185885651 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
34085 | NY | Pharmacy Service Providers |
| Street Address |
113 HOLLAND AVE |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-3410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418895 | Walter Clinton Rockenstire IIi | Nurse Practitioner | 113 Holland Ave, Albany, NY 12208-3410 | 2005-06-27 |
| 1922622976 | Alice Jou | Student in an Organized Health Care Education/Training Program | 113 Holland Ave, Albany, NY 12208-3410 | 2020-06-05 |
| 1356964217 | Katherine Jane Orioli | Student in an Organized Health Care Education/Training Program | 113 Holland Ave, Albany, NY 12208-3410 | 2020-05-26 |
| 1871133686 | Michael John Hayes | Registered Nurse | 113 Holland Ave, Albany, NY 12208-3410 | 2020-01-09 |
| 1619516481 | Kathleen Liberta Fitzgerald | Recreational Therapist Assistant | 113 Holland Ave, Albany, NY 12208-3410 | 2019-12-27 |
| 1346888328 | Christina Mary Rulison | Music Therapist | 113 Holland Ave, Albany, NY 12208-3410 | 2019-12-20 |
| 1225676216 | Michele Ferrauilo | Recreation Therapist | 113 Holland Ave, Albany, NY 12208 | 2019-12-20 |
| 1467090720 | Susan Angela Colletti | Recreation Therapist | 113 Holland Ave, Albany, NY 12208-3410 | 2019-12-18 |
| 1659919918 | Mary Nell Schmitz | Recreation Therapist | 113 Holland Ave, Albany, NY 12208-3410 | 2019-12-18 |
| 1295376192 | Joy Aaron | Social Worker | 113 Holland Ave, Albany, NY 12208-3410 | 2019-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477554095 | Douglas Calvin Anderson Jr. | Pharmacist | 1712a E Broad Ave, East Albany Medical Center, Albany, GA 31705-2611 | 2005-08-04 |
| 1124024278 | Darren William Grabe | Pharmacist | 106 New Scotland Ave, Albany, NY 12208-3425 | 2005-06-23 |
| 1598304511 | Kelsey Hennig | Pharmacist | 106 New Scotland Ave, Albany, NY 12208-3425 | 2019-12-23 |
| 1447789946 | Gregory Gambino | Pharmacist | 1892 Central Ave, Albany, NY 12205-4203 | 2017-06-08 |
| 1336533553 | Lauren Gimlin | Pharmacist | 315 S Manning Blvd, Albany, NY 12208-1707 | 2015-03-25 |
| 1124432109 | Sandra Salverson | Pharmacist | 315 S Manning Blvd, Albany, NY 12208-1707 | 2014-06-17 |
| 1881965069 | Darius Louis Mason | Pharmacist | 25 Hackett Blvd, Mc 69, Albany, NY 12208-3462 | 2012-01-20 |
| 1306169578 | Sunjeev Konduru | Pharmacist | 43 New Scotland Ave, Dept of Pharmacy, 85, Albany, NY 12208-3412 | 2010-03-02 |
| 1043444334 | Manjunath Prakash Pai | Pharmacist | 106 New Scotland Ave, Obrien Rm 204, Acphs, Albany, NY 12208-3425 | 2009-05-14 |
| 1073732079 | Katherine P Cabral | Pharmacist | 106 New Scotland Ave, Albany, NY 12208-3425 | 2007-04-25 |
| Find all providers in ALBANY | ||||
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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.