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NPI Code Detail

MEDICARE: MIDLAND PHARMACY YONKERS CORP.

MEDICARE: MIDLAND PHARMACY YONKERS CORP.
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
13336S0011XSpecialty Pharmacy
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1039486OTHERNYSTATE BOARD

General Provider Information

NPI Number : 1578290433
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDLAND PHARMACY YONKERS CORP.
Provider Business Mailing Address
First Line : 861 MIDLAND AVE
Second Line :
City : YONKERS
State : NY
Zip : 10704-1024
Country : US
Telephone Number : 914-968-0349
Fax Number : 914-968-0357
Provider Business Practice Location Address
First Line : 861 MIDLAND AVE
Second Line :
City : YONKERS
State : NY
Zip : 10704-1024
Country : US
Telephone Number : 914-968-0349
Fax Number : 914-968-0357
Authorized Official
Title or Position : OWNER
Name : BINYAMIN DEZORAIEV
Credential :
Telephone Number : 914-968-0349
Provider Enumeration Date : 08/02/2022
Last Update Date : 09/09/2025

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Practice Location Address:
861 MIDLAND AVE
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10704-1024
Practice Phone: 914-968-0349
Practice Fax: 914-968-0357

Directions to “MIDLAND PHARMACY YONKERS CORP. ” Practice Location

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