Cedra Healthcare LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

033887 Issued in NY

Legal business name

CEDRA HEALTHCARE LLC

Doing business as

Cedra Pharmacy

Practice address

724 Elton Ave
Bronx, NY 10455-1244

Phone

(917) 473-6030

Fax

(844) 666-2066

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Mazen Karnaby

Title

Ceo

Phone

(917) 836-8886

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Cedra Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1245605443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 ELTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104551244",
            "telephone_number": "917-368-8886",
            "fax_number": "844-666-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 ELTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104551244",
            "telephone_number": "917-473-6030",
            "fax_number": "844-666-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDRA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "KARNABY",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-836-8886"
    },
    "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": "033887",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2156010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedra Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedra Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jose Cedeno
• Mercedes Cedeno, RN
• Richard J Cedeno, PA
• Vivian Cedeno, TEACHER
• Cedi Medical Office PLLC
• Cedra Pharmacy Inc
• Lamin Ceesay, CRNA
• Lamin S Ceesay, REGISTERED NURSE
• Vincent M Cefola, DDS
• Shpres Cekaj

• 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 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.