Active NPI
Natan Rafaelov, PHARM. D.
- Pharmacist
- Hicksville, NY
National Provider Identifier
1295015006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 056146
- Practice address
- 210 S Broadway
Hicksville, NY 11801-5002 - Phone
- (516) 433-2711
- Fax
- (516) 681-6422
- NPI assigned
- Aug 24, 2011
- Last updated
- Jun 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 056146 | NY | Primary |
Addresses
Primary practice location
210 S Broadway
Hicksville, NY 11801-5002
Mailing address
210 S Broadway
Hicksville, NY 11801-5002
Phone (516) 433-2711
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056146 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Duane Reade | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591833600000",
"number": "1295015006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S BROADWAY",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118015002",
"telephone_number": "516-433-2711",
"fax_number": "516-681-6422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S BROADWAY",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118015002",
"telephone_number": "516-433-2711",
"fax_number": "516-681-6422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFAELOV",
"first_name": "NATAN",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-24",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.