New Grace Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

NEW GRACE PHARMACY LLC

Practice address

10 Grace Ave
Great Neck, NY 11021-2447

Phone

(516) 472-7688

Fax

(516) 717-4199

NPI assigned

Jun 5, 2017

Organization subpart

No

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

Authorized official

Name

Eduard Yakubov, PHARM DNPI 1538534417

Title

Supervising Pharmacist

Phone

(516) 472-7688

Specialties & licenses 1

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

Practitioners 4

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

• Eduard Yakubov

  • Pharmacist
  • Rego Park, NY
  • NPI 1538534417
  NPD Authorized official
• Edna Ackerly Beeman, MSW, DSW

  • Clinical Social Worker
  • Great Neck, NY
  • NPI 1457411621
  NPD (past)
• Julie Ellen Leclair, PH.D.

  • Clinical Psychologist
  • Hartsdale, NY
  • NPI 1427275197
  NPD (past)
• Stephen Andreopoulos, PHD

  • Clinical Psychologist
  • Ridgewood, NJ
  • NPI 1467597260
  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1851820740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GRACE AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-472-7688",
            "fax_number": "516-717-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRACE AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212447",
            "telephone_number": "516-472-7688",
            "fax_number": "516-717-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW GRACE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "YAKUBOV",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "516-472-7688",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05082733",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Great Neck, NY
• Providers in Great Neck, 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 Jan 27, 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.