59 St Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032821 Issued in NY

Legal business name

59 ST PHARMACY INC

Practice address

5816 4TH Ave
Brooklyn, NY 11220-3810

Phone

(718) 567-0019

Fax

(718) 567-0029

NPI assigned

May 12, 2014

Organization subpart

No

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

Authorized official

Name

Aziz Basman

Title

President

Phone

(718) 567-0019

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• 59 St Pharmacy Doing business as

Locations

Practitioners 2

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

• Sricharan Gummadi, PHARMACIST

  • Pharmacist
  • Brooklyn, NY
  • NPI 1902093792
  NPD (past)
• Radion Krasnov

  • Pharmacist
  • Brooklyn, NY
  • NPI 1083084354
  NPD (past)

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1114338266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203810",
            "telephone_number": "718-567-0019",
            "fax_number": "718-567-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203810",
            "telephone_number": "718-567-0019",
            "fax_number": "718-567-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "59 ST PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "BASMAN",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-567-0019"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04213801",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146637",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "59 St Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.