Shafa Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHAFA PHARMACY LLC

Practice address

621 Middle Neck Rd
Great Neck, NY 11023-1245

Phone

(516) 730-8990

Fax

(516) 730-8968

NPI assigned

Aug 5, 2022

Organization subpart

No

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

Authorized official

Name

Koosha BamdadNPI 1215689567

Title

Managing Member

Phone

(516) 730-8990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Koosha Bamdad

  • Community/Retail Pharmacy
  • Great Neck, NY
  • NPI 1215689567
  NPD Authorized official

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1649907940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231245",
            "telephone_number": "516-730-8990",
            "fax_number": "516-730-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231245",
            "telephone_number": "516-730-8990",
            "fax_number": "516-730-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "BAMDAD",
        "authorized_official_first_name": "KOOSHA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "516-730-8990"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas A Sgaglione, MD
• Shirin Shaban
• Yeranen Shabtai, DDS
• Ronit Shabtian
• Niousha Shadimoasser, M. ED.
• Patrick Sean Aloysius Shafer
• David Shaffer
• Indravadan C Shah, M.D.
• Neil Shah, MD
• Paras P Shah, MD

• Community/Retail Pharmacy in Great Neck, NY
• Providers in Great Neck, 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 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.