Organization Active NPI

Roosevelt Aid Pharmacy Inc

  • Community/Retail Pharmacy
  • Woodside, NY
National Provider Identifier
1154861458
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ROOSEVELT AID PHARMACY INC
Practice address
6508 Roosevelt Ave
Woodside, NY 11377-2928
Phone
(347) 448-6965
Fax
(347) 448-6826
NPI assigned
Mar 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Eduard Katanov
Title
President
Phone
(347) 448-6965

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 033425 NY
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

6508 Roosevelt Ave
Woodside, NY 11377-2928

Mailing address

6508 Roosevelt Ave
Woodside, NY 11377-2928
Phone (347) 448-6965

Other identifiers 1

IdentifierTypeStateIssuer
2167798OtherPK

Other names 1

  • HUDSON PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171031001067 NY DME Supplier - Pharmacy 3274809660 Practice locations: Woodside, NY
O20220623002938 NY Part B Supplier - Mass Immunization (Roster Biller Only) 3274809660 Practice locations: Woodside, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Roosevelt Aid Pharmacy Inc6508 Roosevelt Ave, Woodside, NY 11377-2928(347) 448-6965 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Jul 14, 2017

National Provider Directory

National Provider Directory

Locations

6508 Roosevelt Ave
Woodside, NY 11377
Phone (347) 448-6965

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1154861458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772928",
            "telephone_number": "347-448-6965",
            "fax_number": "347-448-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772928",
            "telephone_number": "347-448-6965",
            "fax_number": "347-448-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT AID PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "KATANOV",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-448-6965"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "033425",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167798",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUDSON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.