Active NPI
Michael Ibrahim
- Pharmacist
- Staten Island, NY
National Provider Identifier
1033003512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 072584
- Practice address
- 1762 Hylan Blvd
Staten Island, NY 10305-1932 - Phone
- (718) 667-6777
- NPI assigned
- Jun 7, 2025
- Last updated
- Jun 7, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 072584 | NY | Primary |
Addresses
Primary practice location
1762 Hylan Blvd
Staten Island, NY 10305-1932
Mailing address
148 Hillcrest Ter
Staten Island, NY 10305-1513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072584 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ibram Pharmacy Inc | Current | Accepting new patients | |
| Ibram Pharmacy Inc | Current | Accepting new patients |
Locations
1762 Hylan Blvd
Staten Island, NY 10305
Phone (718) 667-6777
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749254400000",
"number": "1033003512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 HILLCREST TER",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103051513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1762 HYLAN BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103051932",
"telephone_number": "718-667-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-07",
"last_updated": "2025-06-07",
"certification_date": "2025-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "072584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.