Active NPI
Enuma Edwin Ezeude, RPH
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1699825026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37922
- Practice address
- 236 Bushwick Ave
Brooklyn, NY 11206-2711 - Phone
- (718) 417-9031
- NPI assigned
- Jan 10, 2007
- Last updated
- Jun 29, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 37922 | NY | Primary |
Addresses
Primary practice location
236 Bushwick Ave
Brooklyn, NY 11206-2711
Mailing address
10542 Flatlands 9TH St
Brooklyn, NY 11236-4624
Phone (718) 975-2964
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37922 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sana Pharmacy Inc | Past | Accepting new patients | |
| Al-Shifa Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Brooklyn, NY
- NPI 1356360515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1699825026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10542 FLATLANDS 9TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112364624",
"telephone_number": "718-975-2964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 BUSHWICK AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112062711",
"telephone_number": "718-417-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZEUDE",
"first_name": "ENUMA",
"middle_name": "EDWIN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "37922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.