Healthcare Provider Details

I. General information

NPI: 1093077281
Provider Name (Legal Business Name): HERITAGE CHEMISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ROUTE 25A
MOUNT SINAI NY
11766-2002
US

IV. Provider business mailing address

150 ROUTE 25A
MOUNT SINAI NY
11766-2002
US

V. Phone/Fax

Practice location:
  • Phone: 631-509-4545
  • Fax: 631-509-4554
Mailing address:
  • Phone: 631-509-4545
  • Fax: 631-509-4554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number036686
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number036686
License Number StateNY

VIII. Authorized Official

Name: FRANK BOSIO
Title or Position: CEO
Credential: RPH
Phone: 631-509-4545