Active NPI
Imaan Ezzat
- Pharmacist
- Bronx, NY
National Provider Identifier
1962829424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 121633
- Practice address
- 234 E 149TH Street Lincoln Hospital
Bronx, NY 10451 - Phone
- (718) 579-4657
- Fax
- (718) 579-4744
- NPI assigned
- Mar 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 121633 | MN | Primary |
Addresses
Primary practice location
234 E 149TH Street Lincoln Hospital
Bronx, NY 10451
Mailing address
30-02 39TH Avenue Imaan Ezzat
Apartment a-728
Long Island City, NY 11101
Phone (507) 319-8916
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
| License | State | Type | Specialty |
|---|---|---|---|
| 121633 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1962829424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30-02 39TH AVENUE IMAAN EZZAT",
"address_2": "APARTMENT A-728",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "11101",
"telephone_number": "507-319-8916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 E 149TH STREET LINCOLN HOSPITAL",
"city": "BRONX",
"state": "NY",
"postal_code": "10451",
"telephone_number": "718-579-4657",
"fax_number": "718-579-4744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZZAT",
"first_name": "IMAAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-23",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "121633",
"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 Nov 21, 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.