59 Street RX Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

59 STREET RX INC

Practice address

5816 4TH Ave
Brooklyn, NY 11220-3810

Phone

(718) 567-0019

Fax

(718) 567-0029

NPI assigned

Sep 25, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Sricharan GummadiNPI 1902093792

Title

Owner

Phone

(718) 567-0019

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Smith Street RX Inc

  • Community/Retail Pharmacy
  • Poughkeepsie, NY
  • NPI 1417344615

  Member Of

  NPD member

Practitioners 2

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

• Sricharan Gummadi, PHARMACIST

  • Pharmacist
  • Brooklyn, NY
  • NPI 1902093792
  NPD Authorized official
• Radion Krasnov

  • Pharmacist
  • Brooklyn, NY
  • NPI 1083084354
  NPD (past)

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647734400000",
    "number": "1851876973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203810",
            "telephone_number": "718-567-0019",
            "fax_number": "718-567-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203810",
            "telephone_number": "718-567-0019",
            "fax_number": "718-567-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "59 STREET RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A",
        "authorized_official_last_name": "GUMMADI",
        "authorized_official_first_name": "SRICHARAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-567-0019",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 5623 Nyc Optical LLC
• 566 Wilson Pharmacy Inc.
• 589 Nyc Optical LLC
• 58TH Street Medical, PLLC
• 59 St Pharmacy Inc
• 5TH Ave Eye Care, Inc.
• 5TH Avenue Dental Assoc LLP
• 5TH Avenue Dentistry and Implants, PLLC
• 5TH Avenue Medical Health PC
• 5TH Avenue Pharmacy Inc

• 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 Mar 20, 2022; 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.