Manson Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035082 Issued in NY

Legal business name

MANSON PHARMACY INC

Practice address

13769 Queens Blvd
Briarwood, NY 11435-1845

Phone

(718) 297-4424

Fax

(718) 526-6104

NPI assigned

Oct 19, 2016

Organization subpart

No

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

Authorized official

Name

Olga Yashayeva

Title

Supervising Pharmacist

Phone

(718) 297-4424

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MANSON PHARMACY Other name

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.

• Yasser E Abdel Maksoud

  • Pharmacist
  • Briarwood, NY
  • NPI 1245545144
  NPD (past)
• Hossam Abdel Maksoud

  • Pharmacist
  • Briarwood, NY
  • NPI 1710190269
  NPD (past)
• Michael Notkin

  • Pharmacist
  • Briarwood, NY
  • NPI 1093039497
  NPD (past)
• Fenella Clarise Santos Rosario, PHARMD

  • Pharmacist
  • Briarwood, NY
  • NPI 1902272040
  NPD (past)

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1891246443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13769 QUEENS BLVD",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114351845",
            "telephone_number": "718-297-4424",
            "fax_number": "718-526-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13769 QUEENS BLVD",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114351845",
            "telephone_number": "718-297-4424",
            "fax_number": "718-526-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "YASHAYEVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-297-4424"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04640048",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167112",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANSON PHARMACY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MANSON PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kevin Wilton Ma, MSN
• Ana Miriam Machuca, M.A.
• Maksoud Pharm Inc.
• Hossam Abdel Maksoud
• Manson Health Inc
• Debra Marcelonis
• Yana Masikhaeva
• Suraj Bhakta Mathema, RD
• Ashok Marulappa Mavinakere, MS-CCC/SLP
• Ian J McDonald

• Community/Retail Pharmacy in Briarwood, NY
• Providers in Briarwood, 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 Apr 28, 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.