39TH Street Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

39TH STREET PHARMACY INC.

Doing business as

39TH Street Pharmacy

Practice address

3902 16TH Ave
Brooklyn, NY 11218-5500

Phone

(718) 552-3223

Fax

(718) 552-2320

NPI assigned

Sep 25, 2012

Organization subpart

No

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

Authorized official

Name

Ashur Yakubov

Title

President

Phone

(718) 552-2323

Specialties & licenses 1

Addresses

Other names 1

• 39TH STREET PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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 1

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

• Joy Lazarus, PHARMD

  • Pharmacist
  • Brooklyn, NY
  • NPI 1659777456
  NPD (past)

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1477804953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185500",
            "telephone_number": "718-552-2323",
            "fax_number": "718-552-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185500",
            "telephone_number": "718-552-3223",
            "fax_number": "718-552-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "39TH STREET PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "YAKUBOV",
        "authorized_official_first_name": "ASHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-552-2323"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "39TH STREET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "39TH STREET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 13, 2022; 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.