Bluesman Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

014605 Issued in NY

Legal business name

BLUESMAN PHARMACY INC

Doing business as

Marty's Pharmacy

Practice address

9422 Avenue L
Brooklyn, NY 11236-4809

Phone

(718) 251-1313

Fax

(718) 251-7792

NPI assigned

Nov 13, 2008

Last updated

Sep 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Niedelman, RPHNPI 1902989841

Title

President

Phone

(718) 251-1313

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marty's Pharmacy Doing business as

Practitioners 1

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.

• Jeffrey Niedelman, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1902989841
  NPD Authorized official

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1619121928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9422 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364809",
            "telephone_number": "718-251-1313",
            "fax_number": "718-251-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9422 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364809",
            "telephone_number": "718-251-1313",
            "fax_number": "718-251-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESMAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "NIEDELMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-251-1313",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "014605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00266899",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marty's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.