Malcolm Fombu, M.D.,PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051425-1 Issued in NY

Practice address

10907 101St Ave
Jamaica, NY 11419-1029

Phone

(718) 441-9311

NPI assigned

Mar 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rite Aid of New York Inc

  • Community/Retail Pharmacy
  • New York, NY
  • NPI 1639288129
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Jamaica, NY
  • NPI 1265959779
  NPD (past)

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689703076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13715 96TH PL",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172842",
            "telephone_number": "781-408-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10907 101ST AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114191029",
            "telephone_number": "718-441-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMBU",
        "first_name": "MALCOLM",
        "name_prefix": "Dr.",
        "credential": "M.D.,PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051425-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "025460",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03044200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Fogelman, SLP
• Petal Nicola Fogenay, MSW
• Maria Elisa Montes Fojas, LICENSED CLINICAL SW
• Janet Folarin
• Devena P. Folkes
• Monica Selina Fontenelle, MSED
• Foot Care Oasis P.C.
• Kimberly Tiffany Forbes, MD
• Susan Larae Forbes
• Sonya Ford, CASAC

• Pharmacist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.