Makarious Health Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MAKARIOUS HEALTH CORP

Practice address

1722 Utica Ave Ste 2
Brooklyn, NY 11234-2121

Phone

(718) 968-1600

Fax

(718) 968-1602

NPI assigned

Aug 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John Moussa, PHARM.DNPI 1255655817

Title

Owner

Phone

(917) 544-8056

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Live Well Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Moussa, PHARM.D

  • Pharmacist
  • Brooklyn, NY
  • NPI 1255655817
  NPD Authorized official

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

{
    "created_epoch": "1503100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1326564584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 UTICA AVE STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342121",
            "telephone_number": "718-968-1600",
            "fax_number": "718-968-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 UTICA AVE STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342121",
            "telephone_number": "718-968-1600",
            "fax_number": "718-968-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKARIOUS HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-19",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "MOUSSA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-544-8056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05171751",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Well Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mariam Oluwatoke Makanjuola
• Megan Makarchuk
• Stella Makarenko
• Yelena Makarenko, MS
• Irina Makarevich, M.D.
• Makarious Health Corp
• Alevtina Makarkina, MSED/SPED
• Larisa Makarov, P.A.
• Dina Makarova, LCSW
• Elena Makarova, RN

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.