Isham Broadway Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ISHAM BROADWAY PHARMACY INC

Practice address

4996 Broadway
, 212 TH Street
New York, NY 10034

Phone

(212) 567-3137

Fax

(212) 567-3110

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Satyanarayana NekkantiNPI 1265756449

Title

President

Phone

(212) 567-3137

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Satyanarayana Nekkanti, R,PH

  • Pharmacist
  • New York, NY
  • NPI 1265756449
  NPD Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1386706612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4996 BROADWAY",
            "address_2": "212 TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10034",
            "telephone_number": "212-567-3137",
            "fax_number": "212-567-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4996 BROADWAY",
            "address_2": ", 212 TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10034",
            "telephone_number": "212-567-3137",
            "fax_number": "212-567-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISHAM BROADWAY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "NEKKANTI",
        "authorized_official_first_name": "SATYANARAYANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-567-3137",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "3395236",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01147933",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily H Isenberg, PA
• Jenna Lynn Iseringhausen, NP
• Josephine Isgro, M.D.
• Fawaz Ishak
• Patricia Ishak, PHARM.D.
• Ansley Isham
• Laura Burbeck Isham, P.T.
• Laura Isherwood, LCSW
• Ishibashi Dental P.C.
• Atsuko Ishibashi

• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.