Active NPI
Yelena Rozenfeld-Gofman
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1356664783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I046117-1
- Practice address
- 203 Brighton Beach Ave
Brooklyn, NY 11235-7406 - Phone
- (718) 743-1200
- Fax
- (718) 743-1029
- NPI assigned
- Mar 12, 2010
- Last updated
- Mar 12, 2010
- Sex
- Female
- 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 | I046117-1 | NY | Primary |
Addresses
Primary practice location
203 Brighton Beach Ave
Brooklyn, NY 11235-7406
Mailing address
203 Brighton Beach Ave
Brooklyn, NY 11235-7406
Phone (718) 743-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I046117-1 | Other | NY | NYC BOARD OF PHARMACY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I046117-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 86TH St Pharmacy Corp | Current | Accepting new patients |
Locations
203 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 743-1200
Organizations & group practices 1
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": "1268352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268352000000",
"number": "1356664783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 BRIGHTON BEACH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112357406",
"telephone_number": "718-743-1200",
"fax_number": "718-743-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 BRIGHTON BEACH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112357406",
"telephone_number": "718-743-1200",
"fax_number": "718-743-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZENFELD-GOFMAN",
"first_name": "YELENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-12",
"last_updated": "2010-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I046117-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYC BOARD OF PHARMACY",
"identifier": "I046117-1",
"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 Mar 12, 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.