Pantak Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022664 Issued in NY

Legal business name

PANTAK INC.

Practice address

53-82 65TH Place
Maspeth, NY 11378-1654

Phone

(718) 429-4646

Fax

(718) 335-4421

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Fotakis, RPHNPI 1174855837

Title

President

Phone

(718) 429-4646

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Hill Pharmacy 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

Locations

Practitioners 2

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

• Mark Fotakis, RPH

  • Pharmacist
  • Maspeth, NY
  • NPI 1174855837
  NPD Authorized official
• Christos Panopoulos, BS PHARMACY

  • Pharmacist
  • Brooklyn, NY
  • NPI 1780916445
  NPD

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1467488171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53-82 65TH PLACE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781654",
            "telephone_number": "718-429-4646",
            "fax_number": "718-335-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-82 65TH PLACE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781654",
            "telephone_number": "718-429-4646",
            "fax_number": "718-335-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANTAK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "FOTAKIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-429-4646",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "022664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01569153",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3373874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hill Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Our Town Medical PC
• Our Town Pharmacy, Inc.
• Gina Pacheco, RD, CDN
• Asuncion Que Pacis, MD
• Andrew Paek, L.AC
• Park Lenox Orthopedics, PC
• Park Radiology,P.C.
• Patrycja Gerlak LCSW PC
• Pediatric Psychology of New York, PLLC
• Kathy Peralta, RPH

• Community/Retail Pharmacy in Maspeth, NY
• Providers in Maspeth, 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 4, 2015; 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.