FSNR SNF LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

FSNR SNF LLC

Practice address

1222 East 96TH Street
Brooklyn, NY 11236

Phone

(718) 688-8755

Fax

(718) 688-8774

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Jonathan Shaatal, RPH

Title

Director of Pharmacy

Phone

(718) 688-8755

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Four Seasons Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• FSNR SNF LLC

  • Skilled Nursing Facility
  • Brooklyn, NY
  • NPI 1801301254

  9830459015

  Same PAC ID

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1164435756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 EAST 96TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "718-688-8755",
            "fax_number": "718-688-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 EAST 96TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11236",
            "telephone_number": "718-688-8755",
            "fax_number": "718-688-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FSNR SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "SHAATAL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "718-688-8755",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Geriatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027476",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02829849",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067555",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05632944",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Seasons Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Arlene Frye, LMSW
• Jewel Frye, LLMHC
• Tzivia Fryer
• FSNR Chha LLC
• FSNR Dialysis LLC
• FSNR SNF LLC
• FSNR SNF LLC
• FSNR SNF LLC
• Elie Fteha, MD
• Alber Ftiha, MD

• Long Term Care Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.