Active NPI
Yelizaveta Matatova, PHARMACIST
- Pharmacist
- Flushing, NY
National Provider Identifier
1831409606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053159
- Practice address
- 40-24 College Point Blvd, Suite F600
Flushing, NY 11354 - Phone
- (347) 532-9943
- NPI assigned
- Oct 14, 2010
- Last updated
- Oct 14, 2010
- Sex
- Female
- 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 | 053159 | NY | Primary |
Addresses
Primary practice location
40-24 College Point Blvd, Suite F600
Flushing, NY 11354
Mailing address
40-24 College Point Blvd, Suite F600
Flushing, NY 11354
Phone (347) 532-9943
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
| License | State | Type | Specialty |
|---|---|---|---|
| 053159 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1831409606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40-24 COLLEGE POINT BLVD, SUITE F600",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11354",
"telephone_number": "347-532-9943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40-24 COLLEGE POINT BLVD, SUITE F600",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11354",
"telephone_number": "347-532-9943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATATOVA",
"first_name": "YELIZAVETA",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-14",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.