Individual provider Active NPI

Edward Glazarov

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1538482005
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043405 Issued in NY
Practice address
295 Kings Hwy
Brooklyn, NY 11223-1348
Phone
(718) 382-4400
NPI assigned
Mar 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043405 NY Primary

Addresses

Primary practice location

295 Kings Hwy
Brooklyn, NY 11223-1348

Mailing address

488 Philip Ave
Staten Island, NY 10312-5819
Phone (718) 382-4400

Other identifiers 1

IdentifierTypeStateIssuer
043405OtherNYNYS BOARD OF PHARMACY

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

State licenses

LicenseStateTypeSpecialty
043405NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pharmakon Pharmacy Inc Current Accepting new patients
E & S Pharmacy Corporation Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1538482005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 PHILIP AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125819",
            "telephone_number": "718-382-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231348",
            "telephone_number": "718-382-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZAROV",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "043405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS BOARD OF PHARMACY",
            "identifier": "043405",
            "state": "NY"
        }
    ],
    "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 Mar 11, 2010; 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.