Canal Street Pharmacy Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028411 Issued in NY

Legal business name

CANAL STREET PHARMACY INCORPORATED

Practice address

2029 86TH St., Ground Floor
Brooklyn, NY 11214

Phone

(212) 748-4900

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Hei (Tristan) Liu

Title

Corp. Officer

Phone

(212) 748-4900

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Vince Li, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1447913637
  NPD
• Phoebe Tse, RPH

  • Pharmacist
  • New York, NY
  • NPI 1962681395
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1851595904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 86TH ST., GROUND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11214",
            "telephone_number": "212-748-4900",
            "fax_number": "212-748-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 86TH ST., GROUND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11214",
            "telephone_number": "212-748-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAL STREET PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "HEI (TRISTAN)",
        "authorized_official_title_or_position": "CORP. OFFICER",
        "authorized_official_telephone_number": "212-748-4900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028411",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02892895",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Campoverde, FNP
• Canaan Pharmacy Inc.
• Alexsis Canaan
• Marta Alicia Canaan, M.S., OTR/L
• Shericka Canady, LCSW
• Cali Ann Canal, OTR/L
• Pedro Canals-Ferrat, M.D.
• Kalman Avraham Canant, LCSW
• Shoshana Canant, OTR/L
• Maureen Canaria, OTR

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.