Healthcare Provider Details

I. General information

NPI: 1821986589
Provider Name (Legal Business Name): BENJAMIN PASTORE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

311 E 54TH ST APT 6B
NEW YORK NY
10022-5085
US

V. Phone/Fax

Practice location:
  • Phone: 347-798-9213
  • Fax:
Mailing address:
  • Phone: 978-604-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1000941
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: