Healthcare Provider Details

I. General information

NPI: 1700908829
Provider Name (Legal Business Name): THE NEW YORK HOTEL TRADES COUNCIL AND HOTEL ASSOCIATION OF NEW YORK CI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 ASHLAND PLACE
BROOKLYN NY
11217
US

IV. Provider business mailing address

305 WEST 44TH ST
NEW YORK NY
10036
US

V. Phone/Fax

Practice location:
  • Phone: 718-858-7200
  • Fax: 718-246-9357
Mailing address:
  • Phone: 212-586-6400
  • Fax: 718-246-9357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number023180
License Number StateNY

VIII. Authorized Official

Name: DR. ROY CARROLL LILLY JR.
Title or Position: SUPERVISING PHARMACIST
Credential: PHARMD, RPH
Phone: 718-858-7200