Penn Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034987 Issued in NY

Legal business name

PENN PHARMACY INC

Doing business as

Penn Pharmacy Inc

Practice address

1666 Boston Rd
Bronx, NY 10460-4980

Phone

(718) 484-4280

Fax

(718) 484-4281

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Aleksandr Gulkarov

Title

President

Phone

(718) 484-4280

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• PENN PHARMACY INC Doing business as

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1376098772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10460",
            "telephone_number": "718-484-4280",
            "fax_number": "718-484-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 BOSTON RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604980",
            "telephone_number": "718-484-4280",
            "fax_number": "718-484-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "GULKAROV",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-484-4280"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENN PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angel Yuqing Peng, M.D.
• Jiahao Peng, MD PHD
• Lilly Hong Peng
• Mitchell Peng
• Shalini Penikilapate, MD
• Elizabeth Penn, PSYD
• Katherine Loraine Penn
• Merrill Robert Penn, LCSW
• Norma Penn
• Tyissha K Penn

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, 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 Dec 21, 2016; 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.