Active NPI
Petr Fakhlayev
- Pharmacist
- Woodhaven, NY
National Provider Identifier
1669650784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044767
- Practice address
- 9213 Jamaica Ave
Woodhaven, NY 11421-2108 - Phone
- (917) 337-0934
- NPI assigned
- Jan 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 044767 | NY | Primary |
Addresses
Primary practice location
9213 Jamaica Ave
Woodhaven, NY 11421-2108
Mailing address
6456 Ellwell Cres
Rego Park, NY 11374-5031
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 |
|---|---|---|---|
| 044767 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1669650784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6456 ELLWELL CRES",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113745031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9213 JAMAICA AVE",
"city": "WOODHAVEN",
"state": "NY",
"postal_code": "114212108",
"telephone_number": "917-337-0934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAKHLAYEV",
"first_name": "PETR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-31",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "044767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodhaven, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.