Organization Active NPI

Moishe'S Pharmacy Corp

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1174092951
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MOISHE'S PHARMACY CORP
Practice address
4508 13TH Ave
Brooklyn, NY 11219-2018
Phone
(917) 971-6453
Fax
(718) 686-9998
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Authorized official

Name
Michael Zhang, PHARMD
Title
Pharmacist
Phone
(803) 406-5362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4508 13TH Ave
Brooklyn, NY 11219-2018

Mailing address

4508 13TH Ave
Brooklyn, NY 11219-2018

Other identifiers 2

IdentifierTypeStateIssuer
06075089MedicaidNY
8245306031OtherNYPHARMACY

Other names 1

  • MOISHE'S PHARMACY CORP Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221024000566 NY Part B Supplier - Pharmacy 7113352832 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

4508 13th Ave
Brooklyn, NY 11219
Phone (718) 686-9999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1174092951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192018",
            "telephone_number": "917-971-6453",
            "fax_number": "718-686-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOISHE'S PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "ZHANG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "803-406-5362",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06075089",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "8245306031",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOISHE'S PHARMACY CORP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.