Active NPI
Li Ezra Apothecary LTD
Doing business as ezra pharmacy
- Community/Retail Pharmacy
- Cedarhurst, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 019577
- Legal business name
- LI EZRA APOTHECARY LTD
- Doing business as
- ezra pharmacy
- Practice address
- 690 Central Ave
Cedarhurst, NY 11516-2307 - Phone
- (516) 569-7820
- Fax
- (516) 569-0832
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sidney Langweil
- Title
- Pres /Supervising Pharm
- Phone
- (516) 569-7820
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 019577 | NY | Primary |
Addresses
Primary practice location
690 Central Ave
Cedarhurst, NY 11516-2307
Mailing address
690 Central Ave
Cedarhurst, NY 11516-2307
Phone (516) 569-7820
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2065112 | Other | PK | |
| 01076993 | Medicaid | NY |
Other names 1
- ezra pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170801000011 | NY | Part B Supplier - Pharmacy | 1759652373 | Practice locations: Cedarhurst, NY |
| O20210203001113 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 1759652373 | Practice locations: Cedarhurst, NY |
| O20240813001257 | NY | DME Supplier - Pharmacy | 1759652373 | Practice locations: Cedarhurst, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2210666 | Li Ezra Apothecary LTD | Certificate of waiver | Mar 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Li Ezra Apothecary LTD | Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
604 Central Ave
Cedarhurst, NY 11516
Phone (516) 569-7820
690 Central Ave
Cedarhurst, NY 11516
Phone (516) 374-5934
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Cedarhurst, NY
- NPI 1134263585
-
- Physician Assistant
- Cedarhurst, NY
- NPI 1730270612
-
- Physical Medicine & Rehabilitation Physician
- Brooklyn, NY
- NPI 1912006081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681084800000",
"number": "1982648739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 CENTRAL AVE",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162307",
"telephone_number": "516-569-7820",
"fax_number": "516-569-0832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 CENTRAL AVE",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162307",
"telephone_number": "516-569-7820",
"fax_number": "516-569-0832"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LI EZRA APOTHECARY LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-15",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A",
"authorized_official_last_name": "LANGWEIL",
"authorized_official_first_name": "SIDNEY",
"authorized_official_title_or_position": "PRES /SUPERVISING PHARM",
"authorized_official_telephone_number": "516-569-7820"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "019577",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2065112",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01076993",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ezra pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cedarhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.