Boulevard 9229 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BOULEVARD 9229 LLC

Practice address

9229 Queens Blvd Ste 1I
Rego Park, NY 11374-1072

Phone

(347) 639-1663

Fax

(347) 639-0046

NPI assigned

Dec 8, 2019

Organization subpart

No

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

Authorized official

Name

Ishbay Shukurov

Title

President

Phone

(347) 639-1663

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Alexander Tsynman, MD

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1518993278
  NPD (past)

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

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575763200000",
    "number": "1942847041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 QUEENS BLVD STE 1I",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741072",
            "telephone_number": "347-639-1663",
            "fax_number": "347-639-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 QUEENS BLVD STE 1I",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741072",
            "telephone_number": "347-639-1663",
            "fax_number": "347-639-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD 9229 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-08",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A",
        "authorized_official_last_name": "SHUKUROV",
        "authorized_official_first_name": "ISHBAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-639-1663"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruben Borukhov, LIC ACUPUNCTURIST
• Marina Borukhova, FNP
• Sofiya Borukhova, OTA
• Svetlana Borukhova
• Yana Borukhova, MASTERS ED.
• Tracy Hazan Bousquet, LMSW
• Elina Bover, DPM
• Eva Braun, LCSW
• Eduar Alban Bravo Paredes
• Allia Brickman, LMHC

• Community/Retail Pharmacy in Rego Park, NY
• Providers in Rego Park, 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 Dec 8, 2019; 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.