ETHAN SIMON ASEDO (NPI# 1700118486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700118486 |
| Entity Type | Individual |
| Full Name | ETHAN SIMON ASEDO |
| Credential | RPH |
| Practice Address |
173 Broad Street Staten Island NY 10304-2057 |
| Mailing Address |
173 Broad Street Miller Pharmacy Staten Island NY 10304-2057 |
| Practice Telephone | 7184474127 |
| Mailing Telephone | 7184474127 |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2010-02-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 027362 | NY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00745331 | 05 |
| Street Address |
173 BROAD STREET |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10304-2057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215542923 | Margaret Chifong Tam | Nurse Practitioner | 85 Venice Avenue, Staten Island, NY 10304 | 2020-09-10 |
| 1598397788 | Alexandria & Akea's Playhouse, Inc. | Day Training, Developmentally Disabled Services | 1864 Clove Road, Staten Island, NY 10304 | 2020-02-06 |
| 1548746811 | Bryant Edward Pearson | Technician/Technologist | 664 Bay Street, Staten Island, NY 10304 | 2018-07-19 |
| 1366941668 | Safwat Attia Youssef | Orthopaedic Surgery | 25 Sunrise Terrace, Staten Island, New York, NY 10304 | 2018-02-02 |
| 1699294090 | Kate Lynn Chimienti | Specialist/Technologist | 52 Smith Ter Fl1, Staten Island, NY 10304 | 2017-09-17 |
| 1881117315 | Fun Speech Therapy, P.C. | Early Intervention Provider Agency | 367 St Pauls Ave., Staten Island, NY 10304 | 2017-07-17 |
| 1720517097 | Senada Pelinkovic | Speech-Language Pathologist | 29 Remsen St, Staten Island, NY 10304 | 2017-06-08 |
| 1760927255 | Kpannah Moore | Licensed Practical Nurse | 492 Vanderbilt Avenue, Staten Island, NY 10304 | 2016-12-20 |
| 1689116592 | Rena Li | Registered Nurse | 30 Celebration Lane, Staten Island, NY 10304 | 2016-11-09 |
| 1407304835 | Esther Mitnick | Counselor | 285 Vanderbilt Avenue, State Island, NY 10304 | 2016-09-14 |
| Find all providers in zip 10304 | ||||
| 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 |
|---|---|---|---|---|
| 1083220370 | Minamark M Nageib | Pharmacist | 72 Bridgetown St, Staten Island, NY 10314-6204 | 2020-09-22 |
| 1912513805 | Zakaria Amin | Pharmacist | 382 Ridgewood Ave, Staten Island, NY 10312-2118 | 2020-09-17 |
| 1073136065 | Matthew Thomas Tilatitsky | Pharmacist | 103 Sprague Ave, Staten Island, NY 10307-1931 | 2020-05-25 |
| 1255967220 | Peter J Delorenzo | Pharmacist | 123 Oxford Pl, Staten Island, NY 10301-3016 | 2020-03-21 |
| 1710525514 | Ira Bace | Pharmacist | 146 Freedom Ave, Staten Island, NY 10314-3706 | 2019-12-12 |
| 1760026983 | Hassan Gihad Hamouche | Pharmacist | 213 Norway Ave, Staten Island, NY 10305-3522 | 2019-10-30 |
| 1730722448 | Daniel Nabil Girgis | Pharmacist | 177 Sandalwood Dr, Staten Island, NY 10308-1863 | 2019-10-25 |
| 1437714300 | Miriam Lyubina | Pharmacist | 29 Star Ct, Staten Island, NY 10312-2448 | 2019-05-07 |
| 1134686173 | Muhammad Usman | Pharmacist | 928 Rockland Ave Apt 2, Staten Island, NY 10314-7706 | 2019-02-26 |
| 1831660786 | Amir I Yaqoob | Pharmacist | 92 Slater Blvd, Staten Island, NY 10305-2106 | 2018-12-17 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10304 |
Please comment or provide details below to improve the information on ETHAN SIMON ASEDO.
| 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.