Healthcare Provider Details

I. General information

NPI: 1174500292
Provider Name (Legal Business Name): NAMDOR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 MAIN ST
ROOSEVELT ISLAND NY
10044-0021
US

IV. Provider business mailing address

686 MAIN ST
ROOSEVELT ISLAND NY
10044-0021
US

V. Phone/Fax

Practice location:
  • Phone: 212-644-4125
  • Fax: 212-644-0381
Mailing address:
  • Phone: 212-644-4125
  • Fax: 212-644-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number024488
License Number StateNY

VIII. Authorized Official

Name: MR. BARRY SHERMAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 917-217-2789