Livonia Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

033614 Issued in NY

Legal business name

LIVONIA PHARMACY INC

Doing business as

Livonia Pharmacy Inc

Practice address

625A Livonia Ave
Brooklyn, NY 11207-5301

Phone

(718) 484-8100

Fax

(718) 484-8103

NPI assigned

Jun 19, 2015

Organization subpart

No

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

Authorized official

Name

Imran Siddiqui

Title

President,Owner,Ao

Phone

(718) 484-8100

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• LIVONIA PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1336521988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625A LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-484-8100",
            "fax_number": "718-484-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625A LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075301",
            "telephone_number": "718-484-8100",
            "fax_number": "718-484-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVONIA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "PRESIDENT,OWNER,AO",
        "authorized_official_telephone_number": "718-484-8100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "033614",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152912",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVONIA PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Livingston
• Linda Livingston
• Joan Livingstone, RN
• Livingword Pharmacy Inc (Livingword Pharmacy)
• Stav Livne, MA, LP
• Dimitri Livshits, DO
• Elizaveta Livshits
• Gariy Livshits, LMSW
• Julia Livshits, FNP
• Marina Livshits

• 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 Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.