Active NPI
Grigoriy Yuabov, PHARM.D.
- Pharmacist
- Fresh Meadows, NY
National Provider Identifier
1467887935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 058356
- Practice address
- 7840 164TH St Apt 3D
Fresh Meadows, NY 11366-1209 - Phone
- (347) 209-9254
- NPI assigned
- Sep 3, 2013
- Last updated
- Sep 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 058356 | NY | Primary |
Addresses
Primary practice location
7840 164TH St Apt 3D
Fresh Meadows, NY 11366-1209
Mailing address
7840 164TH St Apt 3D
Fresh Meadows, NY 11366-1209
Phone (347) 209-9254
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
| License | State | Type | Specialty |
|---|---|---|---|
| 058356 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy RX Inc | Current | Accepting new patients | |
| Opti Health, Corp. | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Elmhurst, NY
- NPI 1033528427
-
- Community/Retail Pharmacy
- Rego Park, NY
- NPI 1861900383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1467887935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7840 164TH ST APT 3D",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661209",
"telephone_number": "347-209-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7840 164TH ST APT 3D",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661209",
"telephone_number": "347-209-9254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUABOV",
"first_name": "GRIGORIY",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-03",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "058356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.