Organization Active NPI

Ibram Pharmacy Inc

Doing business as Seaview Pharmacy

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1841616208
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
032585 Issued in NY
Legal business name
IBRAM PHARMACY INC
Doing business as
Seaview Pharmacy
Practice address
1762 Hylan Blvd
Staten Island, NY 10305-1932
Phone
(718) 667-6777
Fax
(718) 667-6778
NPI assigned
Mar 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Feby MousaNPI 1760743140
Title
President
Phone
(718) 667-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 032585 NY Primary

Addresses

Primary practice location

1762 Hylan Blvd
Staten Island, NY 10305-1932

Mailing address

1762 Hylan Blvd
Staten Island, NY 10305-1932
Phone (718) 667-6777

Other identifiers 2

IdentifierTypeStateIssuer
2144907OtherPK
03906172MedicaidNY

Other names 1

  • Seaview Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140801000581 NY DME Supplier - Pharmacy 1951527696 Practice locations: Staten Island, NY
O20210331002445 NY Part B Supplier - Mass Immunization (Roster Biller Only) 1951527696 Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Tax ID family
Ibram Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1756 Hylan Blvd
Staten Island, NY 10305
Phone (718) 667-6777

1762 Hylan Blvd
Staten Island, NY 10305
Phone (718) 667-6777

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1841616208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051932",
            "telephone_number": "718-667-6777",
            "fax_number": "718-667-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051932",
            "telephone_number": "718-667-6777",
            "fax_number": "718-667-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBRAM PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "MOUSA",
        "authorized_official_first_name": "FEBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-667-6777"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144907",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03906172",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaview Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seaview Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.