Individual provider Active NPI

Momana Nasrin Badrul, RPH

  • Pharmacist
  • New York, NY
National Provider Identifier
1982885224
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
049312 Issued in NY
Practice address
534 Hudson St
New York, NY 10014-6114
Phone
(646) 486-1048
Fax
(646) 486-0635
NPI assigned
Nov 15, 2007
Last updated
Nov 15, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 049312 NY Primary

Addresses

Primary practice location

534 Hudson St
New York, NY 10014-6114

Mailing address

4102 23Rd Rd FL 2
Astoria, NY 11105-1519
Phone (718) 726-9510

Other identifiers 1

IdentifierTypeStateIssuer
02043754MedicaidNY

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
049312NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of New York Inc Past Accepting new patients
Rite Aid of New York Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1982885224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 23RD RD FL 2",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051519",
            "telephone_number": "718-726-9510",
            "fax_number": "646-486-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 HUDSON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100146114",
            "telephone_number": "646-486-1048",
            "fax_number": "646-486-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRUL",
        "first_name": "MOMANA",
        "middle_name": "NASRIN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "049312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02043754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.