Organization Active NPI

Vishnev Pharmacy Corp

  • Community/Retail Pharmacy
  • Far Rockaway, NY
National Provider Identifier
1215097456
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
026256 Issued in NY
Legal business name
VISHNEV PHARMACY CORP
Practice address
495 Beach 20TH St
Far Rockaway, NY 11691-3621
Phone
(718) 337-1900
Fax
(718) 337-2277
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Liliya SerebryakovaNPI 1427692938
Title
Owner, Supervising Pharmacist
Phone
(718) 337-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 026256 NY Primary

Addresses

Primary practice location

495 Beach 20TH St
Far Rockaway, NY 11691-3621

Mailing address

495 Beach 20TH St
Far Rockaway, NY 11691-3621
Phone (718) 337-1900

Other identifiers 2

IdentifierTypeStateIssuer
2063856OtherPK
02415910MedicaidNY

Other names 1

  • FRIENDLY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930037326 NY DME Supplier - Pharmacy 6002024981 Practice locations: Far Rockaway, NY
O20210503001938 NY Part B Supplier - Mass Immunization (Roster Biller Only) 6002024981 Practice locations: Far Rockaway, NY

National Provider Directory

National Provider Directory

Locations

495 Beach 20th St
Far Rockaway, NY 11691
Phone (347) 619-5950

Practitioners & affiliated clinicians

Practitioners 1

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1215097456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913621",
            "telephone_number": "718-337-1900",
            "fax_number": "718-337-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913621",
            "telephone_number": "718-337-1900",
            "fax_number": "718-337-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISHNEV PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "SEREBRYAKOVA",
        "authorized_official_first_name": "LILIYA",
        "authorized_official_title_or_position": "OWNER, SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-337-1900"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "026256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063856",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02415910",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRIENDLY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.