Gennadiy Matatov, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

048673 Issued in NY

Practice address

781 Lydig Ave
Bronx, NY 10462-2144

Phone

(718) 822-1348

Fax

(718) 822-1792

NPI assigned

Feb 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Charmar Inc

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1225043623
  NPD Authorized official
• Charmar Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1699780098
  NPD

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1295057552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13957 PERSHING CRES",
            "address_2": "PH",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114351944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 LYDIG AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622144",
            "telephone_number": "718-822-1348",
            "fax_number": "718-822-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATATOV",
        "first_name": "GENNADIY",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Olga Enrile Mata, RN
• Noelia Mata
• Noeralis Mata
• Gabriella Mataev
• Barbara Matallana
• Syna Stanis Matchanickal, DPT
• Adila Afzal Matcheswala, MD
• Dolores Mateo, TEACHER
• Dysiris Mateo, OTR
• Edelin C Mateo

• Pharmacist in Bronx, NY
• Providers in Bronx, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.