Active NPI
Peter R Niyazov, PHARMD
- Pharmacist
- Kew Gardens, NY
National Provider Identifier
1366735763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 050003
- Practice address
- 12510 Queens Blvd
Kew Gardens, NY 11415-1519 - Phone
- (718) 520-3460
- Fax
- (718) 520-3462
- NPI assigned
- May 18, 2011
- Sex
- Male
- 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 | 050003 | NY | Primary |
Addresses
Primary practice location
12510 Queens Blvd
Kew Gardens, NY 11415-1519
Mailing address
12510 Queens Blvd
Kew Gardens, NY 11415-1519
Phone (718) 520-3460
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
| License | State | Type | Specialty |
|---|---|---|---|
| 050003 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305676800000",
"number": "1366735763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12510 QUEENS BLVD",
"city": "KEW GARDENS",
"state": "NY",
"postal_code": "114151519",
"telephone_number": "718-520-3460",
"fax_number": "718-520-3462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12510 QUEENS BLVD",
"city": "KEW GARDENS",
"state": "NY",
"postal_code": "114151519",
"telephone_number": "718-520-3460",
"fax_number": "718-520-3462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIYAZOV",
"first_name": "PETER",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-18",
"last_updated": "2011-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "050003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kew Gardens, NY
- New York Medical and Diagnostic Center
- New York State Neuropsychological State of Mind PC
- Beverly Nichols
- Jessica Karoline Nikiforidis, M.A., CCC-SLP
- Aleksandr Niyazov
- Noah D Freedman MD PC
- Northeast Insomnia & Sleep Medicine,PLLC
- Nova Edge Ny LLC
- Christiane Jivir Nsahlai, M.D/PH.D.
- Nyconfidential Behavioral Medicine PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.