Greis Park Shop Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GREIS PARK SHOP INC

Doing business as

greis park pharmacy

Practice address

602 Merrick Rd
Lynbrook, NY 11563-2306

Phone

(516) 998-0011

NPI assigned

Apr 7, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Michael Borukhov

Title

Owner

Phone

(917) 584-4030

Specialties & licenses 3

Addresses

Other names 1

• greis park pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1952195703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632306",
            "telephone_number": "516-998-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MERRICK RD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632306",
            "telephone_number": "516-998-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREIS PARK SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "BORUKHOV",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-584-4030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "greis park pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward Goziker, D.D.S.
• Marianna Goziker, DMD
• Robert Grabowski, LCSWR
• Ana Granara
• Jaime Maria Greci, LMT
• Jill Beth Gressin, DO
• Margaret Grismer, CCC-SLP
• Lawrence Robert Grosswirth, D.C.
• Nicole Andrea Guerrero, LMSW
• Nancy Dieudonne Gustave

• Pharmacy in Lynbrook, NY
• Providers in Lynbrook, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.