Healthcare Provider Details

I. General information

NPI: 1982478822
Provider Name (Legal Business Name): HEALARIAN LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 11/12/2023
Certification Date: 11/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 3RD AVE
NEW YORK NY
10128-3605
US

IV. Provider business mailing address

PO BOX 286233
NEW YORK NY
10128-0012
US

V. Phone/Fax

Practice location:
  • Phone: 212-317-0828
  • Fax: 212-287-7350
Mailing address:
  • Phone: 212-317-0828
  • Fax: 212-287-7350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ABDELAZIM WAHDAN
Title or Position: SP
Credential:
Phone: 212-317-0828