Kissena RX Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

KISSENA RX PHARMACY INC

Practice address

4207 Kissena Blvd
Flushing, NY 11355-3297

Phone

(917) 563-1079

Fax

(917) 563-1023

NPI assigned

May 1, 2020

Last updated

Mar 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bradley TeohNPI 1821497819

Title

Pharmacist

Phone

(917) 563-1079

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Teoh

  • Pharmacist
  • Staten Island, NY
  • NPI 1821497819
  NPD Authorized official

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1437770310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 KISSENA BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553297",
            "telephone_number": "917-563-1079",
            "fax_number": "917-563-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 KISSENA BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553297",
            "telephone_number": "917-563-1079",
            "fax_number": "917-563-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSENA RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "TEOH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "917-563-1079"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06323317",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY STATE LICENSE",
            "identifier": "038034",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Kirschner
• Kissena Dental Care PC
• Kissena Drugs and Surgical Supply Inc (Kissena Drugs)
• Kissena Medical Imaging,P.C.
• Kissena Plaza Dental P.C.
• Danyelle Kittrell, M.S.
• Rebecca H Kizhner, LCSW
• Shifra Klahr, PH.D.
• Reuven Klappholz
• Alexandra Klein, OTR/L

• Pharmacy in Flushing, NY
• Providers in Flushing, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.