Individual provider Active NPI

Imir Mamirov

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1609393339
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PI28016 Issued in ME
Practice address
1565 W 6TH St
Brooklyn, NY 11204-4928
Phone
(646) 387-2949
NPI assigned
Aug 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PI28016 ME Primary

Addresses

Primary practice location

1565 W 6TH St
Brooklyn, NY 11204-4928

Mailing address

1565 W 6TH St
Brooklyn, NY 11204-4928
Phone (646) 387-2949

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
PI28016MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1609393339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 W 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044928",
            "telephone_number": "646-387-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 W 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044928",
            "telephone_number": "646-387-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIROV",
        "first_name": "IMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PI28016",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 24, 2017; 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.