Healthcare Provider Details

I. General information

NPI: 1386581023
Provider Name (Legal Business Name): FARMACIA LA ESQUINA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 SAINT NICHOLAS AVE
NEW YORK NY
10033-7210
US

IV. Provider business mailing address

1319 SAINT NICHOLAS AVE
NEW YORK NY
10033-7210
US

V. Phone/Fax

Practice location:
  • Phone: 332-296-0150
  • Fax: 332-296-0150
Mailing address:
  • Phone: 332-296-0150
  • Fax: 332-296-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ARATI G SHAH
Title or Position: SUPERVISING PHARMACIST
Credential: RPH
Phone: 332-296-0150