Engrida Samson Mebrahtu

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

067119 Issued in NY

Practice address

1607 Williamsbridge Rd
Bronx, NY 10461-6201

Phone

(347) 691-3922

Fax

(347) 691-3923

NPI assigned

Oct 9, 2020

Sex

Male

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

State licenses

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1164020418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 RIVERSIDE DR APT 11B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255221",
            "telephone_number": "347-886-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616201",
            "telephone_number": "347-691-3922",
            "fax_number": "347-691-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEBRAHTU",
        "first_name": "ENGRIDA",
        "middle_name": "SAMSON",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "067119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Meade, RN
• Raquel Meade, PSYD
• Sylvester Omoregbe Meadows, RDH
• Katherine May Meaney
• Jason Mears, MSW
• Ferial Mechouche
• Noa Mecica, MD
• Med Plus Services, Inc.
• Med Star Surgical & Breathing Equipment Inc.
• Med Star Surgical & Breathing Equipment, Inc.

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, 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 Oct 9, 2020; 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.