Healthcare Provider Details

I. General information

NPI: 1588177349
Provider Name (Legal Business Name): MARPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 CRESCENT ST
LONG ISLAND CITY NY
11101-4213
US

IV. Provider business mailing address

4215 CRESCENT ST
LONG ISLAND CITY NY
11101-4213
US

V. Phone/Fax

Practice location:
  • Phone: 718-337-8030
  • Fax: 917-634-3412
Mailing address:
  • Phone: 718-337-8030
  • Fax: 917-634-3412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number035968
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND SCHWARTZ
Title or Position: OWNER
Credential:
Phone: 718-337-8030