Braddock Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032318 Issued in NY

Legal business name

BRADDOCK PHARMACY LLC

Doing business as

Braddock Pharmacy LLC.

Practice address

23601A Braddock Ave
Bellerose, NY 11426-1143

Phone

(718) 347-1516

Fax

(718) 347-1789

NPI assigned

Nov 15, 2013

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kaliope Chionis

Title

Supervising Pharmacist

Phone

(718) 347-1516

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Braddock Pharmacy LLC. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anuj A Marfatia, RPH

  • Pharmacist
  • Bronx, NY
  • NPI 1003131525
  NPD

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1497185128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236-01A BRADDOCK AVE.",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "718-347-1516",
            "fax_number": "718-347-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23601A BRADDOCK AVE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261143",
            "telephone_number": "718-347-1516",
            "fax_number": "718-347-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADDOCK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "CHIONIS",
        "authorized_official_first_name": "KALIOPE",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-347-1516"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142918",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04396690",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braddock Pharmacy LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isemonne Bonhomme
• Magalie Bonneau, LPN
• Lisa A Borbee, R.PH.
• Mitra Bourbouri
• Denise Renae Bourne, LMSW
• Braddock Pharmacy LLC
• Brainnova Studios Inc
• Janet Brathwaite
• Thelma Brown
• Marla Burroughs, M.S., OTR/L

• Community/Retail Pharmacy in Bellerose, NY
• Providers in Bellerose, 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 Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.