1801280037 NPI number — TWIN PHARMACY 2 CORP

Table of content: (NPI 1801280037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801280037 NPI number — TWIN PHARMACY 2 CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TWIN PHARMACY 2 CORP
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:
1801280037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4073-4075 BROADWAY AV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-927-3100
Provider Business Mailing Address Fax Number:
212-927-3109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4073-4075 BROADWAY AV
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-927-3100
Provider Business Practice Location Address Fax Number:
212-927-3109
Provider Enumeration Date:
03/25/2015

Additional Information

Authorized Official

Authorized Official Last Name:
OLIVO
Authorized Official First Name:
CRISTOBAL
Authorized Official Middle Name:
Authorized Official Title or Position:
BS
Authorized Official Telephone Number:
212-927-3100

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  033408 , 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: 2151059 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com