1104379742 NPI number — UNIK CARE PHARMACY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104379742 NPI number — UNIK CARE PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIK CARE PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104379742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
05/09/2017
NPI Reactivation Date:
07/20/2017

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25-24 30TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASTORIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-726-6774
Provider Business Mailing Address Fax Number:
718-726-9874

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2524 30TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASTORIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11102-2448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-726-6774
Provider Business Practice Location Address Fax Number:
718-726-9874
Provider Enumeration Date:
08/01/2016

Additional Information

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
FARRUKH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
207-299-5289

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 034928 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2164131 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04546058 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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