Individual provider Active NPI

Marina Natanova, PHARMD

  • Pharmacist
  • New York, NY
National Provider Identifier
1407361165
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063541 Issued in NY
Practice address
4915 Broadway
New York, NY 10034-3119
Phone
(212) 304-4646
NPI assigned
Dec 4, 2017
Last updated
Dec 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063541 NY Primary

Addresses

Primary practice location

4915 Broadway
New York, NY 10034-3119

Mailing address

9750 Queens Blvd Apt E17
Rego Park, NY 11374-3266
Phone (718) 508-2187

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

LicenseStateTypeSpecialty
063541NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1407361165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 QUEENS BLVD APT E17",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743266",
            "telephone_number": "718-508-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343119",
            "telephone_number": "212-304-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATANOVA",
        "first_name": "MARINA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.