Healthcare Provider Details

I. General information

NPI: 1861517948
Provider Name (Legal Business Name): ROBELEN CHEMISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PARK AVE
NEW YORK NY
10017-5516
US

IV. Provider business mailing address

100 PARK AVE
NEW YORK NY
10017-5516
US

V. Phone/Fax

Practice location:
  • Phone: 212-682-2817
  • Fax: 212-682-6192
Mailing address:
  • Phone: 212-682-2817
  • Fax: 212-682-6192

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 Number021483
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LEONARD GOLDSTEIN
Title or Position: GENERAL MANAGER
Credential:
Phone: 212-682-2817