47TH Street Enterprise, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032141 Issued in NY

Legal business name

47TH STREET ENTERPRISE, LLC

Practice address

4620 3Rd Ave
Brooklyn, NY 11220

Phone

(718) 439-1570

Fax

(718) 439-1567

NPI assigned

Aug 15, 2013

Organization subpart

No

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

Authorized official

Name

Hassan Muyir

Title

Owner

Phone

(917) 407-7443

Specialties & licenses 4

Addresses

Other identifiers 2

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1710310693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201034",
            "telephone_number": "718-439-1570",
            "fax_number": "718-439-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11220",
            "telephone_number": "718-439-1570",
            "fax_number": "718-439-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "47TH STREET ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "MUYIR",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-407-7443"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RO00122600",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03892660",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141576",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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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 12, 2018; 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.