2818 Fulton Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

2818 FULTON PHARMACY INC

Doing business as

Fulton Pharmacy

Practice address

2818 Fulton St
Brooklyn, NY 11207-2608

Phone

(718) 235-6394

NPI assigned

Dec 4, 2023

Organization subpart

No

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

Authorized official

Name

Rafail MatatovNPI 1972775989

Title

President

Phone

(718) 235-6394

Specialties & licenses 1

Addresses

Other names 1

• Fulton Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 1

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

• Rafail B Matatov, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1972775989
  NPD Authorized official

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1174399844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072608",
            "telephone_number": "718-235-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072608",
            "telephone_number": "718-235-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2818 FULTON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "MATATOV",
        "authorized_official_first_name": "RAFAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-235-6394"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in Brooklyn, 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 Dec 4, 2023; 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.