Waldbaum Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

021087 Issued in NY

Legal business name

WALDBAUM INC

Doing business as

Waldbaums Pharmacy

Practice address

2149 Ralph Ave
Brooklyn, NY 11234-5405

Phone

(718) 531-7682

Fax

(718) 531-3852

NPI assigned

Jul 13, 2006

Last updated

Nov 9, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INCAs reported in NPPES

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

Authorized official

Name

Susan Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• WALDBAUMS PHARMACY Doing business as

Part of

The Great Atlantic and

Locations

Practitioners 3

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.

• Arkadiy Khanimov, PHARM D

  • Pharmacist
  • New York, NY
  • NPI 1265755011
  NPD (past)
• Sabrina Marie Mozzillo, R.PH.

  • Pharmacist
  • Brooklyn, NY
  • NPI 1992973697
  NPD (past)
• Henry Reisner

  • Pharmacist
  • Brooklyn, NY
  • NPI 1083882195
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1629093273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345405",
            "telephone_number": "718-531-7682",
            "fax_number": "718-531-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDBAUM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "021087",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "021087",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274175",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "012741750442",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3399537",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDBAUMS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Lynn Walczyk, PHARM.D., R.PH.
• Barbara C Wald, MSW
• Chaya D Wald, PA
• Erik Wald, DPM
• Michael Wald, LMSW
• Waldemar Majdanski DPM PC
• Takiyah Patricia Walden
• Deborah J Walder, PH.D.
• William T. Waldinger, D.D.S.
• Amy Waldman

• 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 Nov 9, 2007; 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.