Mannix Family Market @ Forest and Richmond Ave LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028451 Issued in NY

Legal business name

MANNIX FAMILY MARKET @ FOREST AND RICHMOND AVE LLC

Practice address

985 Richmond Ave
Staten Island, NY 10314-1501

Phone

(718) 982-8615

Fax

(718) 982-8633

NPI assigned

Jul 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Figueroa Rivera

Title

Third Party Administrator

Phone

(732) 521-8439

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SHOPRITE PHARMACY OF FOREST AND RICHMOND Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amal Imil Aziz, PHARMACIST

  • Pharmacist
  • Staten Island, NY
  • NPI 1841514072
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1003006982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141501",
            "telephone_number": "718-982-8615",
            "fax_number": "718-982-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNIX FAMILY MARKET @ FOREST AND RICHMOND AVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8439"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3354381",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY OF FOREST AND RICHMOND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Patricia Manning, PA
• Christine M. Mannino, M.S.
• Lisa Marie Mannino, OTR/L
• Victoria Mannino
• William Emilio Mannino, FNP-BC
• Mannix Family Market at Veterans Road LLC
• Namala Luke Manohar, MD
• Michael G Manolios, M.D.
• Manor Dental of Staten Island PC
• Manor Road Physical Therapy PC

• Community/Retail Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.