Individual provider Active NPI

Anzhelika Yuabov

  • Pharmacist
  • Fresh Meadows, NY
National Provider Identifier
1033413224
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
055388 Issued in NY
Practice address
6126 188TH St
Fresh Meadows, NY 11365-2713
Phone
(718) 454-4433
NPI assigned
Jan 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055388 NY Primary

Addresses

Primary practice location

6126 188TH St
Fresh Meadows, NY 11365-2713

Mailing address

6126 188TH St
Fresh Meadows, NY 11365-2713

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

LicenseStateTypeSpecialty
055388NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1293926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1033413224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 188TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 188TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652713",
            "telephone_number": "718-454-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUABOV",
        "first_name": "ANZHELIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-02",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.