NPIMap

Organization Active NPI

Branac Ny LLC

Doing business as Coney Island Pharmacy

  • Long Term Care Pharmacy
  • Brooklyn, NY
National Provider Identifier
1548874472
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
BRANAC NY LLC
Doing business as
Coney Island Pharmacy
Practice address
2720 Mermaid Ave
Brooklyn, NY 11224-2006
Phone
(718) 333-2525
NPI assigned
Sep 8, 2020
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Erica MoiseyevNPI 1306126156
Title
Pic
Phone
(718) 333-2525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

2720 Mermaid Ave
Brooklyn, NY 11224-2006

Mailing address

1047 Surf Ave FL 2
Brooklyn, NY 11224-2810
Phone (917) 830-2522

Other names 1

  • Coney Island Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210503001354 NY Part B Supplier - Pharmacy 2365851425 Practice locations: Brooklyn, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Branac Ny LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1548874472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 SURF AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242810",
            "telephone_number": "917-830-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242006",
            "telephone_number": "718-333-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANAC NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "MOISEYEV",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "718-333-2525"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coney Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coney Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 4, 2023; 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.