Individual provider Active NPI

Diana Nisimov, PHARMD

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1467828269
Registry record updated Aug 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
059708 Issued in NY
Practice address
2441 E 3Rd St FL 1
Brooklyn, NY 11223-6043
Phone
(718) 249-6610
NPI assigned
Aug 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 059708 NY Primary

Addresses

Primary practice location

2441 E 3Rd St FL 1
Brooklyn, NY 11223-6043

Mailing address

2441 E 3Rd St FL 1
Brooklyn, NY 11223-6043
Phone (718) 249-6610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
059708NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439596800000",
    "number": "1467828269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 E 3RD ST FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236043",
            "telephone_number": "718-249-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 E 3RD ST FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236043",
            "telephone_number": "718-249-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMOV",
        "first_name": "DIANA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-15",
        "last_updated": "2015-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 15, 2015; 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.