Anna Brook, RPH

Key facts

NPI

1154865822

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

062548 (NY)

Practice address

5456 Myrtle Ave
Ridgewood, NY 11385-3453

Phone

(718) 366-6900

Fax

(718) 366-6901

NPI assigned

Dec 14, 2016

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Yasik 2 Inc Pharmacy · Ridgewood, NY · NPI 1437692134
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 14, 2016.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1154865822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E 18TH ST",
            "address_2": "APT 5E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292147",
            "telephone_number": "917-974-8312",
            "fax_number": "718-366-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5456 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853453",
            "telephone_number": "718-366-6900",
            "fax_number": "718-366-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOK",
        "first_name": "ANNA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "062548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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