Active NPI
Mariya Ibragimova
- Pharmacist
- Rego Park, NY
National Provider Identifier
1619115763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 052960
- Practice address
- 9710 63Rd Rd
Rego Park, NY 11374-1639 - Phone
- (718) 896-2484
- NPI assigned
- Jan 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 052960 | NY | Primary |
Addresses
Primary practice location
9710 63Rd Rd
Rego Park, NY 11374-1639
Mailing address
9710 63Rd Rd
Rego Park, NY 11374-1639
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
| License | State | Type | Specialty |
|---|---|---|---|
| 052960 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1233100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1619115763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9710 63RD RD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113741639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9710 63RD RD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113741639",
"telephone_number": "718-896-2484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAGIMOVA",
"first_name": "MARIYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-28",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "052960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.