Individual provider Active NPI

Violeta Nisonov

  • Pharmacist
  • Jamaica, NY
National Provider Identifier
1841955713
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I068472 Issued in NY
Practice address
8042 Kent St
Jamaica, NY 11432-1545
Phone
(917) 675-1594
NPI assigned
Nov 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X I068472 NY Primary

Addresses

Primary practice location

8042 Kent St
Jamaica, NY 11432-1545

Mailing address

6962 188TH St
Fresh Meadows, NY 11365-3771

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
I068472NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1841955713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6962 188TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8042 KENT ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321545",
            "telephone_number": "917-675-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISONOV",
        "first_name": "VIOLETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I068472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.