Mill Park Drugs Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

016203 Issued in NY

Legal business name

MILL PARK DRUGS INC

Practice address

3948 Richmond Ave
Staten Island, NY 10312-5111

Phone

(718) 356-1789

Fax

(718) 356-1777

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Silvana Mattidi

Title

Owner

Phone

(715) 356-1789

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eltingville Pharmacy Doing business as

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1679676159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125111",
            "telephone_number": "718-356-1789",
            "fax_number": "718-356-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125111",
            "telephone_number": "718-356-1789",
            "fax_number": "718-356-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL PARK DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "MATTIDI",
        "authorized_official_first_name": "SILVANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-356-1789"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "016203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00337471",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05180341",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eltingville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eltingville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Milestones in Motion Physical Therapy Wellness, PC
• Bethanie Milford, LMSW
• Diane Marie Milio, LCSW
• Olga Militsina, FNP
• Mill Park Drugs Inc
• Mina Samy Millad-Aziz, RPH
• Millan Physical Therapy Rehabilitation, P.C.
• Charles Anthony Millan, MS, P.T.
• Tina Suzette G Millare, L.C.S.W.
• Camille Anne Millen, M.S, CCC-SLP

• Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.