MEDICARE: NASCENT DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	015932	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3303574	OTHER		NABP

General Provider Information

NPI Number	:	1457340747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASCENT DRUG INC

Provider Business Mailing Address
First Line	:	5507 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-1113
Country	:	US
Telephone Number	:	718-251-6444
Fax Number	:	718-531-2294

Provider Business Practice Location Address
First Line	:	5507 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-1113
Country	:	US
Telephone Number	:	718-251-6444
Fax Number	:	718-531-2294

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	JONATHAN ZEVON
Credential	:	RPH SP
Telephone Number	:	718-251-6444

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	08/22/2020

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Directions to “NASCENT DRUG INC ” Practice Location

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