Individual provider Active NPI

Vlad Serebryany

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1851749014
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
061595 Issued in NY
Practice address
3948 Richmond Ave
Staten Island, NY 10312-5111
Phone
(718) 356-1789
Fax
(718) 356-1777
NPI assigned
May 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 061595 NY Primary

Addresses

Primary practice location

3948 Richmond Ave
Staten Island, NY 10312-5111

Mailing address

3948 Richmond Ave
Staten Island, NY 10312-5111
Phone (718) 356-1789

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
061595NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gotham RX Inc. Current Accepting new patients
RX Hero Inc. Current Accepting new patients

Locations

3948 Richmond Ave
Staten Island, NY 10312
Phone (718) 356-1789

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1851749014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125111",
            "telephone_number": "718-356-1789",
            "fax_number": "718-333-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125111",
            "telephone_number": "718-356-1789",
            "fax_number": "718-356-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEREBRYANY",
        "first_name": "VLAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-28",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "061595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 4, 2024; 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.