Fellerdom Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034725 Issued in NY

Legal business name

FELLERDOM PHARMACY INC

Practice address

8318 5TH Ave
Brooklyn, NY 11209-4511

Phone

(718) 745-2100

Fax

(718) 745-9367

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Frank Derosa, BSNPI 1932214053

Title

President and Pharmacist

Phone

(718) 745-2100

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WALDINGERS 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.

• Frank A Derosa, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1932214053
  NPD (past) Authorized official
• Constantine Drossos, CPHT

  • Pharmacy Technician
  • Brooklyn, NY
  • NPI 1568710895
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1154414589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094511",
            "telephone_number": "718-745-2100",
            "fax_number": "718-745-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094511",
            "telephone_number": "718-745-2100",
            "fax_number": "718-745-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELLERDOM PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "DEROSA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT AND PHARMACIST",
        "authorized_official_telephone_number": "718-745-2100",
        "authorized_official_credential": "BS"
    },
    "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": "034725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2061097",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00547851",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDINGERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Millie R Fell, MD
• Rachel Fell
• Ashley Marie Fellbaum
• Chaya Mushka Feller
• Maimouna Feller, R.D, C.D.N
• Rivka Fellig
• Sara E Fellig
• Fellowship and Community Center
• Fellowship Resources Center LLC
• Yehudi M Felman

• 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 Nov 15, 2016; 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.