Healthcare Provider Details

I. General information

NPI: 1245956655
Provider Name (Legal Business Name): NYRX PHARMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 10/17/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 B SHERIDAN AVENUE
BRONX NY
10451-3305
US

IV. Provider business mailing address

14 STACEY COURT
PEEKSKILL NY
10566-2507
US

V. Phone/Fax

Practice location:
  • Phone: 718-588-0761
  • Fax: 914-402-1905
Mailing address:
  • Phone: 914-402-1900
  • Fax: 914-402-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NADER A. YOUSSEF
Title or Position: MEMBER
Credential:
Phone: 914-402-1900