NPIMap

Organization Active NPI

Shalom's Diabetes Health and Wellness Center

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1275888463
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
30383 Issued in NY
Legal business name
SHALOM'S DIABETES HEALTH AND WELLNESS CENTER
Practice address
1490 Coney Island Ave
Brooklyn, NY 11230-4714
Phone
(718) 253-4900
Fax
(718) 253-4905
NPI assigned
Jul 13, 2012
Organization subpart
Yes
Parent organization
SHALOM'S PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Mr. Shalom RakhminovNPI 1740594985
Title
Pharmacist
Phone
(718) 253-4900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 30383 NY Primary

Addresses

Primary practice location

1490 Coney Island Ave
Brooklyn, NY 11230-4714

Mailing address

1490 Coney Island Ave
Brooklyn, NY 11230-4714
Phone (718) 253-4900

Other identifiers 1

IdentifierTypeStateIssuer
03297789MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Shaloms Pharmacy Inc2 organizations share this tax ID, including this one
Part of
Shaloms Pharmacy Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1490 Coney Island Ave
Brooklyn, NY 11230
Phone (718) 253-4900

Practitioners & affiliated clinicians

Practitioners 4

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": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1275888463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304714",
            "telephone_number": "718-253-4900",
            "fax_number": "718-253-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304714",
            "telephone_number": "718-253-4900",
            "fax_number": "718-253-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM'S DIABETES HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHALOM'S PHARMACY INC.",
        "enumeration_date": "2012-07-13",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "RAKHMINOV",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-253-4900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "30383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03297789",
            "state": "NY"
        }
    ],
    "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 6, 2025; 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.