Healthcare Provider Details

I. General information

NPI: 1225257587
Provider Name (Legal Business Name): HARLEM HEALTH CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 MORNINGSIDE AVE
NEW YORK NY
10027-4802
US

IV. Provider business mailing address

305 W 44TH ST
NEW YORK NY
10036-5498
US

V. Phone/Fax

Practice location:
  • Phone: 718-606-3863
  • Fax:
Mailing address:
  • Phone: 212-586-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number026290
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID JACOBSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: DMD
Phone: 212-586-6400