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NPI 1356719454ActiveOrganization· Pharmacist· Valley Stream, NY

Pharmacist in Valley Stream, New York, registered in NPPES in September 2015. The authorized official on file is Andre Taylor-Domville, Pharmacist.

Overview

NPI1356719454
StatusActive
Entity typeOrganization
NPI issuedSep 4, 2015
Last updated in NPPESSep 4, 2015

Specialties and licenses

TaxonomyCodeLicenseState
Pharmacist Primary183500000X061081NY

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Pharmacist providers in Valley Stream

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