Healthcare Provider Details

I. General information

NPI: 1356676910
Provider Name (Legal Business Name): ROSLYN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 OLD NORTHERN BLVD
ROSLYN NY
11576-2244
US

IV. Provider business mailing address

1314 OLD NORTHERN BLVD
ROSLYN NY
11576-2244
US

V. Phone/Fax

Practice location:
  • Phone: 516-621-3363
  • Fax: 516-621-3365
Mailing address:
  • Phone: 516-621-3363
  • Fax: 516-621-3365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number029898
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER PAPAZIAN
Title or Position: PRESIDENT/SUPERVISINGR.PH.
Credential: PHARMD
Phone: 516-621-3363