Manio Nicole Mavroukas

Primary specialty

PharmacistTaxonomy code 183500000X

License

053785 Issued in NY

Practice address

6126 188TH St
Fresh Meadows, NY 11365

Phone

(718) 454-4433

NPI assigned

Feb 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• CVS Albany LLC

  • Pharmacy
  • Fresh Meadows, NY
  • NPI 1174627921
  NPD (past)
• CVS Albany LLC

  • Pharmacy
  • Brooklyn, RI
  • NPI 1679459481
  NPD (past)

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1598087116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14716 COOLIDGE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 188TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "718-454-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROUKAS",
        "first_name": "MANIO",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Mateiko
• Lainie Jesmarion Mateo
• Seena Mathunney
• Mylene Matro, PT
• Antoinette Matye
• Esther Max, FNP-BC
• Mazal M Matayev SLP PC
• Melissa Mazer, M.S ED
• Arlene Mazzella, P.A.
• Courtney Shannon McCall, OTR/L

• Pharmacist in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.