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General NPI Number Information
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NPI Number | 1124151675
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Entity Type | Organization
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Legal Business Name | TEE VAL PHARMACY
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 104 W 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10023-4454
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Country | US
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Telephone | 212-877-3090
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Fax | 212-877-3153
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Provider Business Mailing Address
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Address Line | 104 W 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10023-4454
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Country | US
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Telephone | 212-877-3090
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Fax | 212-877-3153
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Authorized Official
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Title or Position | PRES
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Name | FRANK CAMMARATA
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Credential |
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Telephone | 212-877-3090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 004240
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License Number State | NY
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