Healthcare Provider Details

I. General information

NPI: 1952600439
Provider Name (Legal Business Name): NOSTRAND PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 NOSTRAND AVE
BROOKLYN NY
11226-7917
US

IV. Provider business mailing address

1887 NOSTRAND AVE
BROOKLYN NY
11226-7917
US

V. Phone/Fax

Practice location:
  • Phone: 718-282-2956
  • Fax: 718-282-6556
Mailing address:
  • Phone: 718-282-2956
  • Fax: 718-282-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number030625
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HEMAGIRI GAYAM
Title or Position: PRESIDENT
Credential:
Phone: 718-282-2956