Individual provider Active NPI

Leib Gershkovich, R.PH.

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1376712984
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043461 Issued in NY
Practice address
1651 Coney Island Ave
Brooklyn, NY 11230-5849
Phone
(718) 336-8300
Fax
(718) 336-8421
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043461 NY Primary

Addresses

Primary practice location

1651 Coney Island Ave
Brooklyn, NY 11230-5849

Mailing address

620 Barnard Ave
Woodmere, NY 11598-2710
Phone (516) 241-5507

Other identifiers 1

IdentifierTypeStateIssuer
043461OtherNYPHARMACIST NY LICENSE #

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

LicenseStateTypeSpecialty
043461NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Elm Pharmacy, Inc. CurrentSince Dec 30, 1996 Accepting new patients
LGDK LLC Current Accepting new patients
Elm Pharmacy, Inc. Current Accepting new patients

Locations

1651 Coney Island Ave
Brooklyn, NY 11230
Phone (718) 382-2204

Organizations & group practices 3

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1376712984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BARNARD AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982710",
            "telephone_number": "516-241-5507",
            "fax_number": "718-336-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "718-336-8300",
            "fax_number": "718-336-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHKOVICH",
        "first_name": "LEIB",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "043461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST  NY LICENSE #",
            "identifier": "043461",
            "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 Feb 27, 2008; 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.