Active NPI
Richard Marc Etkin, R.PH
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1366766867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 034068-1
- Practice address
- 585 Schenectady Ave
Brooklyn, NY 11203-1809 - Phone
- (711) 860-4536
- NPI assigned
- Mar 26, 2010
- 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 | 034068-1 | NY | Primary |
Addresses
Primary practice location
585 Schenectady Ave
Brooklyn, NY 11203-1809
Mailing address
2657 E 63Rd St
Brooklyn, NY 11234-6811
Phone (347) 702-7518
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034068-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269561600000",
"number": "1366766867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2657 E 63RD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112346811",
"telephone_number": "347-702-7518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 SCHENECTADY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112031809",
"telephone_number": "711-860-4536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETKIN",
"first_name": "RICHARD",
"middle_name": "MARC",
"name_prefix": "Mr.",
"credential": "R.PH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-26",
"last_updated": "2010-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "034068-1",
"primary": true
}
],
"identifiers": [],
"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 26, 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.