Individual provider Active NPI

Irena Pustylnik-Slyuseransky, PHARMD

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1275865636
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050635 Issued in NY
Practice address
1826 Gravesend Neck Rd
Brooklyn, NY 11229-4511
Phone
(718) 872-6655
Fax
(718) 872-6556
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 050635 NY Primary

Addresses

Primary practice location

1826 Gravesend Neck Rd
Brooklyn, NY 11229-4511

Mailing address

2370 E 28TH St
Brooklyn, NY 11229-5034
Phone (718) 449-4949

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
050635NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Homecrest V&I Pharmacy Inc. CurrentSince Aug 28, 2022 Accepting new patients
21 Ave Pharmacy & Medical Supply Inc. Past Accepting new patients
21 Ave Pharmacy & Medical Supply Inc. PastSince May 24, 2020 Accepting new patients

Locations

1826 Gravesend Neck Rd
Brooklyn, NY 11229
Phone (718) 872-6655

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1275865636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 E 28TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295034",
            "telephone_number": "718-449-4949",
            "fax_number": "718-449-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294511",
            "telephone_number": "718-872-6655",
            "fax_number": "718-872-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSTYLNIK-SLYUSERANSKY",
        "first_name": "IRENA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050635",
            "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 Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.