Individual provider Active NPI

Heba Boktor

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1063117901
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
07005001 Issued in NY
Practice address
20 Flagship Cir
Staten Island, NY 10309-3979
Phone
(347) 319-1090
NPI assigned
Mar 31, 2023
Last updated
Mar 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 07005001 NY Primary

Addresses

Primary practice location

20 Flagship Cir
Staten Island, NY 10309-3979

Mailing address

20 Flagship Cir
Staten Island, NY 10309-3979
Phone (347) 319-1090

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
07005001NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1063117901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979",
            "telephone_number": "347-319-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979",
            "telephone_number": "347-319-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOKTOR",
        "first_name": "HEBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "07005001",
            "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 Mar 31, 2023; 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.