Healthcare Provider Details

I. General information

NPI: 1790156545
Provider Name (Legal Business Name): PHARMACY SPECIALIST GROUP II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 E 9TH ST
NEW YORK NY
10009-5335
US

IV. Provider business mailing address

743 EAST 9TH STREET
NEW YORK NY
10009
US

V. Phone/Fax

Practice location:
  • Phone: 212-387-8800
  • Fax: 212-387-8222
Mailing address:
  • Phone: 212-387-8800
  • Fax: 212-387-8222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number033965
License Number StateNY

VIII. Authorized Official

Name: JACOB LEVIEV
Title or Position: PRESIDENT
Credential:
Phone: 212-387-8800