Braddock Pharmacy LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

032318 Issued in NY

Legal business name

BRADDOCK PHARMACY LLC

Practice address

236-01A Braddock Ave.
Bellerose, NY 11426

Phone

(718) 347-1516

Fax

(718) 347-1789

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

Dipesh Shah

Title

Owner

Phone

(718) 347-1516

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anuj A Marfatia, RPH

  • Pharmacist
  • Bronx, NY
  • NPI 1003131525
  NPD

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1801260617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236-01A BRADDOCK AVE.",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "718-347-1516",
            "fax_number": "718-347-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236-01A BRADDOCK AVE.",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "718-347-1516",
            "fax_number": "718-347-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADDOCK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DIPESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-347-1516"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NY",
            "license": "032318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI#",
            "identifier": "1497185128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magalie Bonneau, LPN
• Lisa A Borbee, R.PH.
• Mitra Bourbouri
• Denise Renae Bourne, LMSW
• Braddock Pharmacy LLC
• Brainnova Studios Inc
• Janet Brathwaite
• Thelma Brown
• Marla Burroughs, M.S., OTR/L
• Wayne Burte, DC

• Community Based Hospice Care Agency in Bellerose, NY
• Providers in Bellerose, NY by specialty
• Community Based Hospice Care Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.