115 Irving Ave Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035113 Issued in NY

Legal business name

115 IRVING AVE PHARMACY INC

Doing business as

Atlantic Pharmacy & Surgical Supplies

Practice address

1706B Atlantic Ave
Brooklyn, NY 11213-1206

Phone

(718) 484-2260

Fax

(718) 484-2261

NPI assigned

Dec 28, 2006

Last updated

Apr 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devang RavalNPI 1104001817

Title

Pharmacy Manager

Phone

(718) 484-2260

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ATLANTIC PHARMACY & SURGICAL SUPPLIES Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Devang Laheri Raval, RPH

  • Pharmacist
  • Brooklyn, NY
  • NPI 1104001817
  Authorized official Same address or phone
• Padmaja Annamaneni, MD

  • Psychiatry Physician
  • Perth Amboy, NJ
  • NPI 1205914520
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1932265642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706B ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131206",
            "telephone_number": "718-484-2260",
            "fax_number": "718-484-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706B ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131206",
            "telephone_number": "718-484-2260",
            "fax_number": "718-484-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "115 IRVING AVE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "RAVAL",
        "authorized_official_first_name": "DEVANG",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "718-484-2260"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2062245",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00833192",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTIC PHARMACY & SURGICAL SUPPLIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Apr 24, 2017; 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.