Active NPI
Julia Sudakov, RPH
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1275617060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041798
- Practice address
- 509 Ditmas Ave
Brooklyn, NY 11218-5001 - Phone
- (718) 675-0055
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 041798 | NY | Primary |
Addresses
Primary practice location
509 Ditmas Ave
Brooklyn, NY 11218-5001
Mailing address
10 Dahlia St
Staten Island, NY 10312-1125
Phone (347) 562-4558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041798 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ditmas Pharmacy Corp | Pharmacist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacist
- Brooklyn, NY
- NPI 1255415030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275617060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 DAHLIA ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103121125",
"telephone_number": "347-562-4558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 DITMAS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112185001",
"telephone_number": "718-675-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUDAKOV",
"first_name": "JULIA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "041798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.