Organization Active NPI

Lefferts Pharmacy Inc

Doing business as Kellys Pharmacy

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1427137819
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
024299 Issued in NY
Legal business name
LEFFERTS PHARMACY INC
Doing business as
Kellys Pharmacy
Practice address
5825 5TH Ave
Brooklyn, NY 11220-3819
Phone
(718) 439-6360
Fax
(718) 492-1234
NPI assigned
Nov 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Mohammad Ahamd
Title
SPH President
Phone
(718) 439-6360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 024299 NY Primary

Addresses

Primary practice location

5825 5TH Ave
Brooklyn, NY 11220-3819

Mailing address

5825 5TH Ave
Brooklyn, NY 11220-3819
Phone (718) 439-6360

Other identifiers 2

IdentifierTypeStateIssuer
2062028OtherPK
01900994MedicaidNY

Other names 1

  • KELLYS PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5825 5th Ave
Brooklyn, NY 11220
Phone (718) 439-6360

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1427137819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203819",
            "telephone_number": "718-439-6360",
            "fax_number": "718-492-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203819",
            "telephone_number": "718-439-6360",
            "fax_number": "718-492-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEFFERTS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-04",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "AHAMD",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "SPH PRESIDENT",
        "authorized_official_telephone_number": "718-439-6360"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "024299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2062028",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01900994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KELLYS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 13, 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.