Individual provider Active NPI

Bazhena Fidman, PHARM.D

  • Pharmacist
  • New York, NY
National Provider Identifier
1366722803
Registry record updated Aug 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
055954 Issued in NY
Practice address
75 Christopher St
New York, NY 10014-4236
Phone
(212) 627-2662
Fax
(212) 627-4782
NPI assigned
Aug 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055954 NY Primary

Addresses

Primary practice location

75 Christopher St
New York, NY 10014-4236

Mailing address

139 Hylan Blvd
FL2
Staten Island, NY 10305-2005

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

LicenseStateTypeSpecialty
055954NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC Past Accepting new patients
CVS Albany LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1314403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314403200000",
    "number": "1366722803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HYLAN BLVD",
            "address_2": "FL2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CHRISTOPHER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144236",
            "telephone_number": "212-627-2662",
            "fax_number": "212-627-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDMAN",
        "first_name": "BAZHENA",
        "name_prefix": "Ms.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-27",
        "last_updated": "2011-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2011; 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.