=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114070364
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 92 PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2007
-----------------------------------------------------
Last Update Date | 01/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1938 2ND AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10029-6303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-426-6484
-----------------------------------------------------
Fax | 212-426-9913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1938 2ND AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10029-6303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-426-6484
-----------------------------------------------------
Fax | 212-426-9913
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. FATIMA CHAUDHRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 212-426-6484
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------