Individual provider Active NPI

Hanna Legesse Yigzaw

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1952075319
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
067404 Issued in NY
Practice address
1961 Southern Blvd
Bronx, NY 10460-1419
Phone
(718) 299-0299
NPI assigned
Aug 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04071600 NJ
Pharmacist 183500000X 067404 NY Primary

Addresses

Primary practice location

1961 Southern Blvd
Bronx, NY 10460-1419

Mailing address

601 W 190TH St Apt 21
New York, NY 10040-3247

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
28RI04071600NJMDPharmacist
067404NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Antigua Local Pharmacy LLC CurrentSince Aug 15, 2021 Accepting new patients

Locations

1961 Southern Blvd
Bronx, NY 10460
Phone (347) 794-0531

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1952075319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 190TH ST APT 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104601419",
            "telephone_number": "718-299-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIGZAW",
        "first_name": "HANNA",
        "middle_name": "LEGESSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04071600",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "067404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.