Individual provider Active NPI

Ann Yacoub

  • Pharmacist
  • Wantagh, NY
National Provider Identifier
1750105383
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
065064 Issued in NY
Practice address
2087 Wantagh Ave
Wantagh, NY 11793-3913
Phone
(516) 224-3015
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 065064 NY Primary

Addresses

Primary practice location

2087 Wantagh Ave
Wantagh, NY 11793-3913

Mailing address

2971 Shore Dr
Merrick, NY 11566-5224
Phone (646) 300-3968

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

State licenses

LicenseStateTypeSpecialty
065064NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Worx Incorporated CurrentSince Nov 17, 2024 Accepting new patients

Locations

2087 Wantagh Ave
Wantagh, NY 11793
Phone (347) 503-9390

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1750105383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 SHORE DR",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665224",
            "telephone_number": "646-300-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2087 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933913",
            "telephone_number": "516-224-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.