Polkor Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031209 Issued in NY

Legal business name

POLKOR PHARMACY INC

Practice address

831 Manhattan Ave
Brooklyn, NY 11222-2507

Phone

(718) 389-0389

Fax

(718) 389-0475

NPI assigned

Apr 19, 2012

Organization subpart

No

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

Authorized official

Name

Yong Tae Chang, RPHNPI 1730350455

Title

Pharmacist

Phone

(718) 389-0389

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Markowa Apteka Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yong Tae Chang, RPH

  • Pharmacist
  • Mount Vernon, NY
  • NPI 1730350455
  NPD Authorized official
• Agnieszka Malgorzata Lasak

  • Pharmacist
  • Stroudsburg, PA
  • NPI 1811540636
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1730446485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112222507",
            "telephone_number": "718-389-0389",
            "fax_number": "718-389-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 MANHATTAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112222507",
            "telephone_number": "718-389-0389",
            "fax_number": "718-389-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLKOR PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "TAE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-389-0389",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "031209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5805099",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03457150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Markowa Apteka Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Markowa Apteka Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suzanne L. Polivy
• Laura Polizzi, M.D
• Morana Poljak-Varenika, M.D
• Hugh Lenox Polk, M.D.
• Julie Polk
• Esther Poll Rubin
• Malkie Poll
• Daniel Polla, M.D.
• Gina Pollaci-Schillaci, M.S. ED.
• Adinah Pollack

• 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 Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.