Etba Pharmacy Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

027244 Issued in NY

Legal business name

ETBA PHARMACY INC.

Practice address

530 E 138TH St
Bronx, NY 10454-4906

Phone

(718) 665-2018

Fax

(718) 665-3575

NPI assigned

Oct 18, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kamala Iyer, PHARMACIST

Title

Pharmacist/Manager

Phone

(718) 665-2018

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Brook Pharmacy Doing business as

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1508855990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 138TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544906",
            "telephone_number": "718-665-2018",
            "fax_number": "718-665-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 138TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544906",
            "telephone_number": "718-665-2018",
            "fax_number": "718-665-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETBA PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "IYER",
        "authorized_official_first_name": "KAMALA",
        "authorized_official_title_or_position": "PHARMACIST/MANAGER",
        "authorized_official_telephone_number": "718-665-2018",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "027244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02646808",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "027244",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brook Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Christian Manansala Estrellado, M.D.
• Robert Estren
• Robert Anthony Esty
• Vivienne Esty
• Ida K Etah, FNP
• Flora Eteng
• Yakini Etheridge, PH.D.
• Brittanie J Etienne, PA-C
• Dominique E Etienne
• Elizabeth Etienne, M.D.

• Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.