New York Ave Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

018288 Issued in NY

Legal business name

NEW YORK AVE PHARMACY INC

Practice address

3307 Church Ave
Brooklyn, NY 11203-2711

Phone

(718) 856-8048

Fax

(718) 469-0424

NPI assigned

Apr 7, 2007

Last updated

Aug 20, 2015By 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. Elwaleed M IbrahimNPI 1831368315

Title

Pharmacist /Owner

Phone

(718) 856-8048

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

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.

• Elwaleed Mubarak Ibrahim, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1831368315
  NPD Authorized official
• Muhammad Khalique Qureshi

  • Pharmacist
  • Brooklyn, NY
  • NPI 1871774356
  NPD (past)
• Imelda L Vital, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
  • NPI 1821405887
  NPD (past)
• Louis Gessai Vital, MD

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1780805069
  NPD (past)

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1649393596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-856-8048",
            "fax_number": "718-469-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032711",
            "telephone_number": "718-856-8048",
            "fax_number": "718-469-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK AVE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ELWALEED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACIST /OWNER",
        "authorized_official_telephone_number": "718-856-8048",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "018288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00850642",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.