Organization Active NPI

Medtown Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1013317452
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MEDTOWN PHARMACY, INC.
Practice address
517 Park Ave
Suite 102
Brooklyn, NY 11205-1783
Phone
(718) 875-1505
Fax
(718) 875-1507
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Baruch Lichtenstein
Title
President
Phone
(718) 875-1505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

517 Park Ave
Suite 102
Brooklyn, NY 11205-1783

Mailing address

517 Park Ave Suite 102
Brooklyn, NY 11205-1783
Phone (718) 875-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151113002367 NY DME Supplier - Pharmacy 0840500294 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

517 Park Ave
Ste 102
Brooklyn, NY 11205
Phone (718) 875-1505

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1013317452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 PARK AVE SUITE 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051783",
            "telephone_number": "718-875-1505",
            "fax_number": "718-875-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 PARK AVE",
            "address_2": "SUITE 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051783",
            "telephone_number": "718-875-1505",
            "fax_number": "718-875-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTOWN PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "LICHTENSTEIN",
        "authorized_official_first_name": "BARUCH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-875-1505"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.