{"npi":"1982940763","type":"NPI-2","status":"active","name":{"display":"Staten Island Pharmacy Inc.","other":[],"organization_name":"STATEN ISLAND PHARMACY INC.","authorised_official":"Nicky Legakis"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1807 VICTORY BLVD","city":"STATEN ISLAND","state":"NY","postal_code":"103143515","country_code":"US","phone":"7184485200","fax":"7184485311"},{"purpose":"MAILING","street_1":"1807 VICTORY BLVD","city":"STATEN ISLAND","state":"NY","postal_code":"103143515","country_code":"US","phone":"7184485200"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"03548143","state":"NY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20151207002658","type_code":"12-73","type_desc":"PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)","state":"NY","pac_id":"0143475764"}]},"enumeration_date":"2012-12-23","last_updated":"2022-01-31","_meta":{"source":"NPPES","snapshot_date":"2022-01-31","doc_url":"https://findmynpi.com/api"}}