Healthcare Provider Details

I. General information

NPI: 1679690424
Provider Name (Legal Business Name): J LEON LASCOFF & SON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 LEXINGTON AVE
NEW YORK NY
10028-1404
US

IV. Provider business mailing address

1209 LEXINGTON AVE
NEW YORK NY
10028-1404
US

V. Phone/Fax

Practice location:
  • Phone: 212-288-9500
  • Fax: 212-737-7392
Mailing address:
  • Phone: 212-288-9500
  • Fax: 212-737-7392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number000001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number000001
License Number StateNY

VIII. Authorized Official

Name: MS. WAI SIM CHEUNG
Title or Position: PHARMACIST
Credential: RPH
Phone: 212-288-9500