MBG Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025600 Issued in NY

Legal business name

MBG PHARMACY CORP

Practice address

119 Church Ave
Brooklyn, NY 11218-3917

Phone

(718) 686-7343

Fax

(718) 626-7492

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Maksim Glezer, RPHNPI 1033157201

Title

Pres

Phone

(917) 597-7759

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• IMAGE PRESCIRPTION CENTER Doing business as

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

Tax ID family

MBG Pharmacy Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Image Prescription Center LTC

  • Long Term Care Pharmacy
  • Brooklyn, NY
  • NPI 1437978129
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Image Prescription Center LTC

  • Long Term Care Pharmacy
  • Brooklyn, NY
  • NPI 1437978129
  NPPES parent name

Practitioners 1

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

• Maksim Glezer, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1033157201
  NPD Authorized official

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1457578551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183917",
            "telephone_number": "718-686-7343",
            "fax_number": "718-686-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183917",
            "telephone_number": "718-686-7343",
            "fax_number": "718-626-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBG PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "GLEZER",
        "authorized_official_first_name": "MAKSIM",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "917-597-7759",
        "authorized_official_credential": "RPH"
    },
    "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": "025600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02368656",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064959",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMAGE PRESCIRPTION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Alexandra Mazzuki, CCC-SLP
• Sonia Mbabazi, PHD
• Nneka Mbadiwe, NP
• Mbberenberg Psychological Services, P.C.
• MBF Rehab Physical & Occupational Therapy PLLC
• Onyeka Ijeoma Mbiamnozie, LPN
• Pascal Mbilain-Sama
• Ayana Mbonu, LMHC
• MBS LTD
• Fay MC Allister, RN

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 8, 2016; 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.