Genesis Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GENESIS PHARMACY

Practice address

6558 Fresh Meadow LN
Fresh Meadows, NY 11365-2012

Phone

(718) 353-3555

NPI assigned

Oct 29, 2018

Organization subpart

No

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

Authorized official

Name

Igor Borukhov

Title

Owner

Phone

(718) 790-8811

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1457828345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6558 FRESH MEADOW LN",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652012",
            "telephone_number": "718-353-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6558 FRESH MEADOW LN",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652012",
            "telephone_number": "718-353-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "BORUKHOV",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-790-8811"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.