Individual provider Active NPI

Yury Arabov

  • Pharmacist
  • Glen Cove, NY
National Provider Identifier
1942487624
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
046301 Issued in NY
Practice address
100 Village SQ Ste 130
Glen Cove, NY 11542-2669
Phone
(516) 201-2820
Fax
(516) 201-0819
NPI assigned
Jan 25, 2008
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 046301 NY Primary

Addresses

Primary practice location

100 Village SQ Ste 130
Glen Cove, NY 11542-2669

Mailing address

100 Village SQ Ste 130
Glen Cove, NY 11542-2669
Phone (516) 201-2820

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
046301NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Square RX Corp. CurrentSince Jun 1, 2023 Accepting new patients

Locations

100 Village Sq
Ste 130
Glen Cove, NY 11542
Phone (516) 201-2820

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1942487624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VILLAGE SQ STE 130",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422669",
            "telephone_number": "516-201-2820",
            "fax_number": "516-676-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VILLAGE SQ STE 130",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422669",
            "telephone_number": "516-201-2820",
            "fax_number": "516-201-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARABOV",
        "first_name": "YURY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "046301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.