Dr. Robert Kennedy Awadallah, Pharm.D, ANP, MBA
Pharmacist in Port Jefferson, NY. Individual provider (NPI-1).
NPI number1043855596
StatusActive
Last updated in NPPESNov 7, 2019
Details
- NPI
- 1043855596
- Entity type
- Individual (NPI-1)
- Name
- Dr. Robert Kennedy Awadallah
- Credential
- Pharm.D, ANP, MBA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 7, 2019
- Last updated
- Nov 7, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 046732-1 | NY | Yes |
| 1835N0905X | Pharmacist, Nuclear | 046732-1 | NY |
Practice location
200 Belle Terre RdPort Jefferson, NY 11777-1968
Phone 631-474-6000
Mailing address
134 Evelyn RdMineola, NY 11501-3206
Phone 516-376-6412
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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