1841732237 NPI number — NEW YORK PHARMACY NETWORK, LLC

Table of content: (NPI 1841732237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841732237 NPI number — NEW YORK PHARMACY NETWORK, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK PHARMACY NETWORK, LLC
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:
1841732237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
444 MERRICK RD
Provider Second Line Business Mailing Address:
SUITE LL5
Provider Business Mailing Address City Name:
LYNBROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11563-2460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-531-5000
Provider Business Mailing Address Fax Number:
877-531-5006

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 MERRICK RD STE LL5
Provider Second Line Business Practice Location Address:
LL5
Provider Business Practice Location Address City Name:
LYNBROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11563-2461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-531-5000
Provider Business Practice Location Address Fax Number:
877-531-5006
Provider Enumeration Date:
11/16/2016

Additional Information

Authorized Official

Authorized Official Last Name:
FRIEDMAN
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
COEO
Authorized Official Telephone Number:
516-531-5000

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: 035055 , 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: 2166435 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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