Inna Ichtchenko, BS IN PHARMACY

Primary specialty

PharmacistTaxonomy code 183500000X

License

045788 Issued in NY

Practice address

1250 Hylan Blvd
Staten Island, NY 10305-1943

Phone

(718) 815-2600

Fax

(718) 815-2095

NPI assigned

Mar 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Old Town Pharmacy, Inc

  • Community/Retail Pharmacy
  • Staten Island, NY
  • NPI 1063574739
  NPD Authorized official

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1083938047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051943",
            "telephone_number": "718-815-2600",
            "fax_number": "718-815-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051943",
            "telephone_number": "718-815-2600",
            "fax_number": "718-815-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHTCHENKO",
        "first_name": "INNA",
        "name_prefix": "Mrs.",
        "credential": "BS IN PHARMACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Icahn School of Medicine at Mount Sinai
• Ichthysroe, LLC
• Ics Care
• Idan Sharon, MD, PC
• Liza Idelchik, DDS
• Awele Idemudia

• Pharmacist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.