4TH Ave Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032368 Issued in NY

Legal business name

4TH AVE PHARMACY INC.

Doing business as

4TH Avenue Pharmacy

Practice address

5002 4TH Ave
Brooklyn, NY 11220-1814

Phone

(718) 492-1500

Fax

(718) 492-4028

NPI assigned

Jan 2, 2014

Last updated

Jun 5, 2025By 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

Muhammad Siddiuqe

Title

President

Phone

(732) 372-1023

Specialties & licenses 1

Addresses

Other names 1

• 4TH AVENUE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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, and the practitioner matching its NPPES authorized official.

• Sung Ae Chang, R.PH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1891019618
  NPD (past)

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1669893079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201814",
            "telephone_number": "718-492-1500",
            "fax_number": "718-492-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201814",
            "telephone_number": "718-492-1500",
            "fax_number": "718-492-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH AVE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "SIDDIUQE",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-372-1023"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4TH AVENUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Jun 5, 2025; 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.